38例四肢血管损伤诊治体会

Experiences of diagnosis and treatment of 38 cases with vascular injuries in extremities

目的 对38例四肢主要血管损伤的救治进行回顾性分析。方法 2001年5月-2004年12月救治四肢主要血管损伤38例，其中男28例，女10例；年龄4．5-60岁，平均34．6岁。全组手术清创和探查后，针对不同的情况选择血管修复方法。结果 采用血管端吻合15例（39．4％），血管修补8例（21．1％），自体静脉移植8例（21．1％），死亡1例（2．6％），截肢6例（15．8％）。结论 四肢主要血管损伤救治原则是保证生命安全后尽快重建血液循环、恢复肢体功能；正确诊断、快速救治是前提；快速止血是重点；强调对深静脉的修复并正确处理感染性血管损伤。

Objective To review our experiences in treatment of 38 cases with vascular injuries in extremities. Methods Retrospective stady the 38 cases in our department from 2001.5 --2004.12, with their age from 4.5 years old to 60years old （ mean34.6 years ole）among which 28 cases were male. Managements were selective according to individual instance. Results Vascular anastomosis was performed on 15cases （39.4%）, direct repairing suture on 8 eases （21.1% ）, the other 8 cases were grafted with auto- vein or artificial blood vessel, 1 patient died during the treatment （ 2.6 % ）, 6ca.se.s suffered from amputation （ 15.8 % ）. Conclusions The nain principle of therapy must be focused on ensuring patient＇s life firstly and then their extremities. Immediate treatment, should be based on prompt but right diagnosis. Rapid hemostasis and precise repair of vascular wounds should also be emphasized.