摘要
目的总结颈动脉损伤患者救治的临床经验。方法 2003年1月-2006年6月,抢救5例颈动脉损伤患者。男3例,女2例;年龄21～35岁。其中左右颈总动脉各1例,左锁骨下动脉2例,左椎动脉1例。合并损伤:左颈内静脉贯通伤1例,左胸导管及交感神经损伤1例,食道损伤1例,左锁骨骨折1例。受伤至入院时间20 min～3个月。受伤原因:刀刺伤3例,误食缝衣针伴感染1例,车祸伤1例。采用血管吻合修复颈总动脉及椎动脉3根、侧壁修补修复左锁骨下动脉1根、左颈内静脉1根及自体血管移植术修复左锁骨下动脉1根。术中输血量1 000～11 000 mL,平均3 800 mL。结果所有患者均抢救成功,伤口Ⅰ期愈合,经1～3年随访,无神经功能障碍。结论颈动脉损伤救治成功的关键在于尽早做出诊断,快速有效的急救及选择正确的治疗方法。
Objective To summarize the successful experience of rescuing patients with carotid artery trauma.Methods From January 2003 to June 2006,5 patients with carotid artery trauma were rescued,each patient had one of following arteries injuried： left common carotid artery,right common carotid artery,left subclavian artery and left vertebral artery.Among them,3 males and 2 females aged 21-35 years.Meanwhile,complicated trauma occurred respectively： left internal jugular vein penetrating injury in 1,thoracic duct injury and left sympathetic trunk injury in 1,esophagus injury in 1,and left clavicle fracture in 1.The time from injury to hospitalization was 20 minutes to 3 months.Three patients were caused by knife penetrating injury,1 by foreign body complicated infection and 1 by traffic injury.Thecommon carotid arteries in 2 and vertebral artery in 1 were repaired by anastomosis,and the subclavian arteries were repaired by suture or autologous grafts.The amount of blood transfusion during operation ranged from 1 000 to 11 000 mL with 3 800 mL average.Results All the rescue efforts were successful,and all the wounds healed by first intention,neurological dysfunction didn＇t appear during 1-3 years follow-up period.Conclusion The key to successful treatment on patients with carotid artery trauma is to make early diagnosis,rapid and effective first aid,and to adopt the adequate treatment.
出处
《华西医学》
CAS
2012年第12期1852-1854,共3页
West China Medical Journal
关键词
颈总动脉
锁骨下动脉
椎动脉
损伤
抢救
Common carotid artery
Subclavian artery
Vertebral artery
Trauma
Rescue
