四肢急性血管损伤诊治(附73例报告)

EVALUATION OF ACUTE VASCULAR INJURIES OF EXTREMITIES: REPORT OF SEVENTY-THREE CASES

诊治四肢急性血管的损伤,如何才能收到良好的效果,目前仍然是一重要的课题。作者从1977年1月～1991年5月的73例中,发现了一些有关重要问题。指出在诊断时动脉搏动的存在不能排除血管损伤,尤其上肢血管损伤伴有较高的神经损伤发生率,血管造影并无必要;术中应对受伤的血管及软组织进行彻底的清创,选择恰当的血管修复方法,不要遗漏对复合伤的处理,注意神经损伤应早期修复。

The diagnosis and treatment of acute vascular injuries of extremities are not difficult, but still there are some important problems to be resolved, by which the curative effect can be improved. Seventy-three cases with acute vascular injuries of the extremities treated in our division have been studied retrospectively in a period of fourteen years from January of 1977 to May of 1991. We pointed out that the possibility of vascular injuries can not be ruled out by the finding of palpable distal pulses, higher incidence of nerve injuries usually associated with vascular injuries in the upper limbs, it is unnecessary to have angiography, thorough debridement should be carried out in wounded blood vessel and its surronunding soft tissues. The methods for vascular repairment should be properly selected; the treatment of the combined injuries could not be left out, and the nerve injuries should be repairea as soon as possible.