摘要
目的探讨医源性锁骨下动脉损伤的诊断和有效治疗方法。方法对1997年7月至2009年1月,11例医源性锁骨下动脉损伤的救治进行回顾性分析,本组7例行血管修补,2例行人造血管移植,1例行大隐静脉桥接,l例行直接端-端吻合。结果手术修复成功10例,死亡1例。动脉修复术后l年随访,均可清晰地触及桡动脉搏动。其中1例并发臂丛神经损伤,术后1年随访未完全恢复。结论医源性锁骨下动脉损伤是一种严重而复杂的血管损伤,大多数医源性锁骨下动脉损伤是可以避免的,对血管损伤应做到诊断迅速,快速有效止血,及时补充血容量和纠正休克。手术修复应根据具体情况选择适当切口,选择合理的手术入路和适当的手术方法,是手术安全、成功的关键。
Objective To research the diagonosis and effective treatments of iatrogenic subclavian artery injuries. Methods From July 1997 to January 2009 ,the clinical data of 11 cases of subclavian vascular injury were analysed retrospectively. There were 7 cases treated by direct suture,2 cases by artificial vascular prosthesis graft,1 case by autogenous saphaneous vein graft and l case by endto-end anasto-mosis. Ther cause of injury,classifications and conplications were analyzed. Results Extremities survived and got good function in 10 cases. One cases died in this group. Incomplete recovery of the brachial nerve was abserved in 1 cases. After subclavian vessels reconstruction, clear pulses is observed in radial arteries. There was no visible tumefaction of extrimities after repair of injured the veins when examined at the time of follow-up. Conclusion Iatrogenic subclavian artery injury is serious and complicated. Amlost all operative injuries of iatrogenic subclavian artery are preventable. For subclavian vascular injuries, most impor tant thing is correct diagnosis, quick hemostasis and proper treatment. The management such as direct suture, artificial vascular prosthesis graft,autogenous saphaneous＇vein graft and endto-end anastomosis should be selected according to the type of vascular injuries. To improve the therapeutic effectiveness,The selection of a reasonable incision approach and a suitable surgery method is the key of a safe and successful operation.
出处
《重庆医学》
CAS
CSCD
北大核心
2011年第12期1187-1188,共2页
Chongqing medicine
关键词
锁骨下动脉
损伤
手术
subclavian artery
injury
surgery
