筋膜缝合技术在主动脉瘤腔内修复术中的应用研究  

The application of fascial suturing technique in the endovascular aneurysm repair

作　　者：黄国飞[1] 李俊[1] 贺俊文[1] 杨勇[1] 李龙龙 Huang Guofei;Li Jun;He Junwen;Yang Yong;Li Longlong(People's Hospital of Deyang City, Deyang, Sichuan, 618000, China)

机构地区：[1]德阳市人民医院,四川德阳618000

出　　处：《当代医学》2018年第9期32-34,共3页Contemporary Medicine

摘　　要：目的探讨筋膜缝合技术(fascia suturing technique,FST)在主动脉瘤腔内修复术(endovascular aneurysm repair,EVAR)中的安全性及可行性。方法回顾性分析2013年1月~2016年12月德阳市人民医院行EVAR手术23例患者共41处股动脉切口采用筋膜缝合技术闭合股动脉,如术中缝合失败,立即行股动脉切开缝合,观察手术技术成功率及术后切口并发症发生情况。结果整体技术成功率为92.7%(38/41)。2例患者术中切口止血不满意、1例患者缝合后血管狭窄导致下肢缺血,经扩大腹股沟切口,暴露股动脉后于直视下缝合解决。术后1周内有1例患者出现切口出血,经局部压迫后治愈;2例患者切口出现脂肪液化,经局部换药后治愈;术后1个月有1例患者发现股动脉假性动脉瘤形成(3.5 cm×2 cm),在彩超引导下予假性动脉瘤内静注凝血酶后缓解。以后随访未见有新的切口并发症发生。结论筋膜缝合技术EVAR术中闭合股动脉切口安全有效、并发症少、操作简便、易于掌握,并能减少医疗费用,值得临床推广使用。Objective To evaluate the safety and feasibility of fascia suturing technique(FST)in the endovascular aneurysm repair.Methods A retrospective analysis in January2013to December2016in the people's hospital of deyang city,23patients with EVAR and41femoral artery incision using FST.If FST was failure,immediately cutdown femoral artery and sutured.We observed the success rate of surgical technique and postoperative incision complications occurred.Results The overall technical success rate was92.7%(38/41).Two patients were not satisfied with the incision hemostasis during the operation,1patient was sutured and the blood vessel stenosis resulted in ischemia of the lower extremity,and then the incision of the inguinal canal was enlarged and the femoral artery was exposed to the anterior suture.In1week after operation,1patient had incisional bleeding and was cured after partial compression.In2patients,fat liquefaction was found in the incision,which was cured after local administration.One patient had femoral artery pseudoaneurysm(3.5cm×2cm)in1month after operation,which was relieved by the thrombin injection in pseudoaneurysm.No new incision complications were observed in follow-up.Conclusion FST in the endovascular aneurysm repair is safe and effective,which has less complications,easy to master the technique and can reduce medical expenses.It is worth the clinical promotion.

关 键 词：股动脉 主动脉瘤 筋膜缝合术 经皮穿刺术 

分 类 号：R654.3[医药卫生—外科学]