腘动脉损伤延迟后的保肢治疗  

SALVAGE OF LOWER LIMB WITH LONG-TIME INJURY OF POPLITEAL ARTERY

作　　者：丁真奇[1] 翟文亮[1] 康两期[1] 练克俭[1] 郭延杰[1] 郭林新[1] 洪加源[1] 

机构地区：[1]解放军第175医院骨科,福建漳州363000

出　　处：《中国修复重建外科杂志》2002年第6期382-383,共2页Chinese Journal of Reparative and Reconstructive Surgery

摘　　要：目的　提供一种能提高动脉损伤延迟后的保肢治疗方法。　方法　从 1 990年起 ,在常规骨折内固定和血管吻合等治疗基础上 ,经小腿前外侧入路 ,彻底切除缺血坏死肌肉 ,一期缝合皮肤和踝关节或足三关节融合方法 ,治疗 2 1例时间超过 1 2小时的动脉损伤患者。　结果　术后切口 期愈合 1 3例 , 期愈合 5例 , 期愈合 1例 ;保肢成功 1 9例 ,2例截肢 ,截肢率为 9.5%。随访 2～ 4年 ,平均 2 .9年 ,存活的肢体均行足踝关节功能位融合 ,恢复了大部分行走功能。　结论　彻底切除小腿缺血坏死的肌肉 ,一期缝合皮肤是治疗动脉损伤延迟后保肢的一种较理想的补救方法。Objective To evaluate the rate of salvage of lower limb with long time injury of popliteal artery. Methods Twenty one patients with injury of popliteal artery were treated. The interval between injury and repair of artery ranged from 12hrs to 48 hrs. The essences of operation were thorough debridement of the ischemic and necrotic muscles, primary suture of wound, and repair of popliteal artery on the basis of reduction and fixation of fracture. Results The limb salvage were achieved in 19 cases. The saved limbs could fulfill the basic function of walk. Conclusion Thorough debridement of ischemic and necrotic muscle and primary suture of wound were reasonable methods which could treat long time injury of popliteal artery without amputation.

关 键 词：GUO动脉损伤 保肢治疗 延迟诊断 手术方法 

分 类 号：R658.3[医药卫生—外科学]