腘动脉损伤手术修复与介入治疗的对比分析

Comparison of surgical repair and interventional treatment of popliteal artery injury

目的探讨腘动脉损伤手术修复术和介入治疗对急性腘动脉损伤的临床疗效。方法收集2020年10月至2021年4月云南大学附属医院收治的6例急性腘动脉损伤(PAI)患者的临床资料,对救治时间、多学科团队(MDT)协作模式、传统手术和介入开通血管的方法等影响截肢率的因素进行分析。结果6例急性PAI患者中,5例患者保肢成功,1例患者因严重毁损伤截肢。术后,有2例行腔内介入治疗患者的患肢并发不同程度的慢性缺血。结论PAI是一种较常见的周围血管损伤,发病急,损伤后较易造成严重的肢体缺血,且常导致截肢的严重后果。与介入治疗相比,开放手术可有效缩短术前准备时间,提高保肢率,降低截肢率。部分PAI患者可选择行介入治疗,但应严格把握适应证,加强其并发症的防治。

Objective To explore the clinical efficacy of surgical repair and interventional treatment of popliteal artery injury.Method Clinical data of 6 patients with acute traumatic popliteal artery injury(PAI)admitted to Affiliated Hospital of Yunnan University from October 2020 to April 2021 was collected,and treatment time,multidisciplinary team(MDT)collaboration model,traditional surgery and interventional methods of opening blood vessels that affect the rate of amputation were analyzed.Result 5 patients had limbs salvaged successfully,and 1 patient was amputated due to severe multiple injuries in 6 patients with PAI.There were 2 cases of intravascular intervention therapy patients with different degrees of chronic ischemia after the operation of the affected limb.Conclusion PAI is a common peripheral vascular injury with acute onset and severe ischemia of limbs,which can lead to amputation.Compared with interventional therapy,open surgery can effectively shorten the preoperative preparation time,effectively increase the limb salvage rate,and reduce the rate of amputation.Interventional therapy can be considered for some PAI patients,but the indications should be analyzed carefully to improve the prevention and treatment of complications.