63例肢体主干动脉损伤的显微外科修复治疗体会

The therapic comprehend of repairing the limb's injured bole arterial by using microsurgical technique

目的探讨采用显微外科技术修复各类肢体主干动脉损伤的方法。方法回顾性分析我院自1998年6月至2005年1月收治63例主干动脉伤施行血管端端吻合、动脉破裂口修补、血管移植修复等治疗的病人临床资料。结果本组63例采用显微外科技术修复各类肢体主干动脉损伤的患者中57例肢体血管循环恢复正常,其中有随访者56例,随访时间最长2年,最短5个月。随访者中46例肢体功能恢复正常,11例肢体残留不同程度障碍2例为感染后吻合口破裂出血,2例为血管栓塞肢体坏死。2例死亡,均为严重复合伤者,主干动脉重建时间最长达17小时。结论采用显微外科技术及时正确修复各类肢体主干动脉损伤,是保证患者肢体血运重建,恢复患者肢体功能的关键,肢体主干动脉损伤修复的时限不应作硬性限制,可根据损伤部位,损伤类型全身状况及技术条件等全面考虑而决定。

Objective The aim of the study was to explore the method of repairing the injured limb's bole arterial by using microsurgical technique. Methods To retrospectively analyse the clinical data of 63 patients whose limb's bole arterial were injured and were performed end-to-end anastomosis restoring arteriorrhexis and vasotransplantation. Results The circulation of limb's blood vessel recovered fully in 53 cases by using microsurgical technique. 56 cases had gotten follow-up visit and the longest follow-up time was 2 years the shortest follow-up time was 5 months the limb's function recovered fully in 46 cases there were some disorder in 11 cases the anastomotic stoma cracked after infectionem in 2 cases the limb's become necrosis caused by embolism in 2 cases 2 cases dead caused by combined wound. the longest reconstruction time of the injured limb's bole arterial was 17 hours. Conclusions To restore to injured bole arterial by using microsurgical technique was the key point of blood vessel reconstructing and recovering limb's function,the reconstruction time can be determined according to the patients' state and the specification.