摘要
目的探讨髂股血管损伤的特点及救治方法。方法回顾性分析2002年5月—2006年11月收治的29例髂股动静脉损伤病例的临床资料。29例中,行血管修复27例,其中动静脉联合人工血管移植端端吻合11例,自体大隐静脉移植端端吻合7例,利用自体大隐静脉行血管缺损修补6例,动脉内膜修复取栓并修补2例,血管端端吻合1例。结果本组29例,27例血管修复成功,随访6～12个月,平均随访时间9个月,肢体血液供应良好,深静脉修复的4例长期站立时有下肢不同程度的肿胀。另2例由于肢体已发生坏死或血管床广泛栓塞而截肢。无死亡病例。结论髂股血管损伤发病凶险,早期表现隐匿。仔细的体格检查和彩色多普勒检查有助于尽早发现,而手术探查仍然是最好的诊断方式。早期诊断及尽早恢复肢体血运是救治成功的关键。
Objective To evaluate the clinical features and treatment of acute iliac and femoral vascular injuries. Methods The clinical data of 29 patients from May 2002 to November 2006 with iliac and femoral vascular injuries were analyzed retrospectively. Out of 29 cases, 27 cases underwent emergency vascular reconstructions, including 11 cases with combined reconstructions of arteries and veins by end to end artificial graft anastomosis, and 7 cases by autologous grafts end to end anastomosis. Six cases underwent repairs of vascular defects with flaps of autologous great saphenous vein. Two cases received intraarterial embolus removal and renovations of the interior membrane, and 1 case with direct end to end vascular anastomsis. Results Vascular restorations were successful in 27 cases and the follow-up time ranged from 6 to 12 months. Blood supplies to the lower extremities were all excellent. There were various degrees of swellings after long time standing in 4 patients undergoing restorations of deep veins. Two cases underwent high level amputations because of necrosis of limbs or widespread intraarterial embolism. Conclusion The clinical presentations of iliac and femoral vascular injuries are usually insidious. Careful physical examination and color Doppler test are useful for early diagnosis. Early and immediate restoration of the blood supply to the extremity is essential for a successful treatment,
出处
《中华普通外科杂志》
CSCD
北大核心
2007年第10期743-745,共3页
Chinese Journal of General Surgery
关键词
创伤和损伤
血管外科手术
Wounds and injuries
Vascular surgical procedures
