周围动脉损伤的治疗

TREATMENT OF PERIPHERAL ARTERIAL INJURIES

总结周围动脉损伤74例,以上肢和下肢主干动脉为多。其中,行血管端端吻合28例,裂口修补12例,自体静脉移植20例,动脉结扎7例,未探查血管7例。74例中死亡1例,截肢16例。根据本组病例治疗结果,认为动脉损伤后应尽早处理,其方法主要采用血管修复。软组织及血管的彻底清创,良好的修复技术,骨折妥善固定,彻底止血,与动脉伴行的主干静脉的探查与修复,远端肢体筋膜充分减压,恰当引流以及术中术后局部及全身抗凝剂的应用对治疗动脉损伤均十分重要。

Seventy-four cases of peripheral arterial injuries in recent 30 years were reported. Mostof them were main arteies in extremeties. Twenty-eight cases were performed end to end anastomosis and 7 of them received amputation for various complications. We also performed 12 cases of reparatidn of wall,20 cases of vascular grafts and 7 cases of arterial ligation. There were 16 cases of amputation and one death. We think that artemal injuries should be operated as soon as possible. Arteial reconstruction was mostly used,including reparation of wall,end-to-end anastomosis and autovenous graft. Other procedures should be emphasized, such as complete debridement of the soft tissue and vessels, appropriate fixation of fracture,exploration and reconstruction of major veins,enough decompression of interfascia compartment,proper drainage of would and good surgical skill. Local and general anticoagulation were good to treatment of arterial injuries during and after operation.