人工血管移植修复腰椎间盘髓核摘除后髂总动脉损伤:病例分析  

Artificial blood vessel transplantation for common iliac artery injury following lumbar discectomy:a case analysis

作　　者：罗万荣[1] 易伟宏[1] 王敏[1] 黄曹[1] 刘东宁[1] 杨大志[1] 王尔天[1] 

机构地区：[1]广东医学院附属南山医院脊柱外科,广东省深圳市518052

出　　处：《中国组织工程研究》2014年第43期7018-7022,共5页Chinese Journal of Tissue Engineering Research

基　　金：广东省自然科学基金(S2012010008531)~~

摘　　要：背景:国内外文献报道腰椎间盘手术并发腹部大血管损伤发生率较少,可一旦发生病情危急,抢救及处理不当可导致患者死亡或肢体功能障碍。目的:探讨腰椎间盘髓核摘除致腹侧大血管损伤的发生原因、诊断及防治措施。方法:复习1例腰椎间盘髓核摘除致髂总动脉损伤的诊断及防治措施。结果与结论:患者L4/5椎间盘突出症行L4、L5右侧椎板减压髓核摘除导致髂总动脉损伤,通过及时诊断、采取外科干预及人工血管移植,抢救成功。大血管的损伤与手术操作、解剖、病理等因素有关,对于术中不能明确原因的椎间隙渗血伴有术中血压突然下降提示可能有大血管的损伤;准确诊断及迅速采取外科干预是抢救生命的关键。BACKGROUND：Major abdominal vascular injury is a seldom serious complication during lumbar discectomy. Once occurring, it wil cause critical condition, and incorrect rescue and operation wil lead to patient’s death or functional disorder of the limbs. OBJECTIVE：To explore the cause, diagnosis, prevention and treatment action for major abdominal vascular injury caused by lumbar discectomy. METHODS：One case of common iliac artery injury caused by lumbar discectomy was reviewed in the aspects of diagnosis, prevention and treatment action. RESULTS AND CONCLUSION：The case suffered from common iliac artery injury caused by lumbar discectomy of right L 4-5 vertebrae, and achieved successful rescue by timely diagnosis, surgical intervention and artificial blood vessel transplantation. Injury of the vessels is relevant with many factors, including surgical operation, anatomy, pathology, etc. Unexplained intervertebral hemorrhage accompanied with sudden drop of blood pressure during surgery hints the possible occurrence of major vascular injury. Accurate diagnosis and instant surgical intervention is the key to rescue the patient’s life.

关 键 词：椎间盘移位 解剖 髂动脉 

分 类 号：R318[医药卫生—生物医学工程]