创伤性动脉瘤和动静脉瘘

Traumatic Aneurysm and Arteriovenous Fistula

目的：为了进一步探讨创伤性动脉瘤和动静脉瘘的手术方法，我院血管外科分析了１９６３年６月～１９９５年１２月，经手术治疗的创伤性动脉瘤和动静脉瘘９６例。其中创伤性动脉瘤５５例，含６３个动脉瘤，动静脉瘘４１例，含４３个动静脉瘘。方法：根据血管造影和手术发现，将创伤性动脉瘤和动静脉瘘各分为四个类型。手术方法包括直接修补、单纯或四头结扎、瘤或瘘切除然后行对端吻合或大隐静脉或人造血管移植。结果：除１例左颈总动脉根部动脉瘤伴左颈总动脉—无名静脉瘘术后１９小时死于弥漫性血管内凝血外，其余无死亡。动脉瘤和动静脉瘘得到随访的分别为７９．６％和７８．０％。远期随访效果较佳。结论：不同类型的创伤性动脉瘤和动静脉瘘，应采用不同的手术方法。

Aim: In order to go further into operative treatment for traumatic aneurysm and arteriovenous fistula, fifty five patients with sixty three traumatic aneurysms and forty one patients with forty three traumatic arteriovenous fistulae were operated and analysed from June 1963 to Dec.1995. Methods: According to the arteriographic appearance and operative findings, the traumatic aneurysms and arteriovenous fistulas have been divided into four types respectively. Operative procedures consisted of direct repair, simple or quadrate ligation, resection followed by direct anastomosis, or by saphenous vein or prosthesis grafting. Results: All were alive but one patient died 19 hours postoperatively due to DIC. The follow up rates were 79.6% (aneurysm) and 78.0% (arteriovenous fistula) respectively. Conclusion: Different types of traumatic aneurysms and arteriovenous fistulae should be rendered by different operative procedures.