四肢血管损伤的处理与肢体再灌注损伤的初步观察

The Management of Blood Vessel Injury of Extremities and an Observation on Reperfusion Injury of Limbs

本文报道了１９８６年８月至１９９３年７月收治的６６例四肢血管损伤病人，治愈６４例，截肢２例，无死亡病例。文章就有关诊断、急救、手术处理等问题作了讨论，并观察了３００例病人与再灌注损伤有关的酶学改变，观察到血管损伤修复后一定时间内组织细胞坏死程度较缺血时为甚，认为再灌注加重了原有的缺血损伤，应用清热解毒、活血化瘀之类药物对抗再灌注造成的损伤，促进肢体功能恢复。

Sixty-Six cases with blood vessel injury of extremities from Aug. 1986to July 1993 were reported. Among thern, 64 cases were cured and 2 caseswere treated with amputation. The diagnosis, emergency treatment andoperative management were discussed. The enzyme changes related to reper-fusion injury were observed in 30 cases. It was shown that the cellular andtissue necrosis a certain period after the repair of blood bessel injury is moreserious than that during ischemia,showing that the original ischemic injuryis aggravated byreperfusion. Herbal medicines with effects of clearing heat,eliminating toxic material, activating blood circulation and removing bloodstasis were applied to reduce the reperfusion injury and promote the restora-tion of activity of limbs.