摘要
目的 研究腘动脉损伤及早诊断与合理治疗方法的选择. 方法 选取25例诊治和随访资料完整的腘动脉损伤患者,其中锐性损伤6例（24%）,钝性损伤19例（76%） ;合并开放性骨折10例（40%）,闭合性骨折及膝关节脱位13例（52%）,静脉损伤3例（12%）,神经损伤5例（20%）;分析延迟诊断原因,比较腘动脉损伤原因、类型、合并损伤及发病到救治时间与预后的关系. 结果 手术修复腘动脉同时取栓20例（80%）,血管腔内治疗5 例（20%）;血供完全恢复16例（64%）,改善3例（12%）,截肢6例（24%）. 发病6-8 h内救治者截肢率明显低于8 h以上者（P〈0. 05）;钝性损伤或与合并损伤同时存在者截肢率明显高于锐性损伤者（P〈0. 05）. 结论 受伤至治疗的时间〈8 h、合并膝关节脱位及周围损伤是致残的主要原因. 及早诊断、以手术修复同时取栓为主要治疗手段,血管腔内治疗是有效的补充治疗手段.
Objective To investigate the early diagnosis and rational treatment of popliteal artery injury so as to im-prove the lower limb salvage rate. Methods The clinical and follow-up data integrity of 25 patients with popliteal artery injury was systematically studied. In these patients , 19（76%）cases were blunt injury and 6（24%） cases were penetrating injury. The combined injury included open fracture in 10 cases（40%） ,the knee joint dislocation with closed fracture of lower limb in 13（52%）,nerve injury in 5（20%） and venous injury in 3（12%）,respective-ly. The cause of delayed diagnosis and relationship between prognosis and type of injury, complications, the dura-tion from injured to treatment time were analyzed. Results 20 cases were operated to repair the popliteal artery. Endovascular treatment in 5 cases, the blood supply completely recovered （64%） in 16 cases, improved in 3 cases （12%） , 6 cases （24%） amputed, respectively. Rate of amputation within 6-8 hours was significantly lower than that of the more than 8 hours from the injuried to treatment time （ P〈0. 05 ） . Amputation rate in blunt injury and combined injury was significantly higher than that of sharp injury （ P〈0. 05 ） . Conclusion The duration from inju-ry to surgery more than 8 h, combined with knee joint dislocation and wound around knee is a major cause of mor-bidity. Operation with arterial thrombectomy is the main treatment, while endovascular treatment is a complementa-ry treatment to save the lower limb.
出处
《安徽医科大学学报》
CAS
北大核心
2015年第10期1504-1506,共3页
Acta Universitatis Medicinalis Anhui
关键词
腘动脉损伤
诊断
手术治疗
动脉取栓
血管腔内治疗
popliteal artery injury
diagnosis
operation
arterial embolectomy
endovascular treatment
