急性周围血管损伤的诊断和治疗(附42例报道)

Diagnosis and treatment of acute peripheral vascular injury

目的回顾性分析42例周围血管损伤的临床表现、诊断及处理特点。方法对42例患者急诊手术,探查处理损伤血管,术中、术后给予抗凝溶栓药物治疗。结果40例开放性血管损伤,2例闭合性血管损伤。30例动脉损伤,8例静脉损伤,4例动静脉联合损伤。38例患者痊愈出院(90.5%),3例患者血管损伤截肢(7.1%),1例肱动脉闭合性损伤,未能及时治疗,形成假性动脉瘤,二期切除并重建肱动脉。结论急性周围血管损伤应尽早明确诊断并给予手术治疗,可用自体血管、人造血管重建重要血管,缩短患肢缺血时间,常规应用抗血栓治疗,降低致残率。

Objective To review 42cases of acute peripheral vascular injuries and to retrospectively analyze their characteristics of clinical manifestation, diagnosis and treatment. Methods 42 cases received emergency surgical treatment. Anticoagulation and thrombolysis drugs were applied during and after the operation. Results In the 42 cases, there were 40 open wounds, 2 closed wound, 30 arterial injuries, 8 venous injury, and 4 combined injuries. 38 patients recovered（90. 5% ） , 3 with lower extremity vascular trauma received amputation（7.1%） , and 1 with brachial artery closed injury who refused surgical treatment developed pseudoaneurysm. Conclusion Acute peripheral vascular injuries must be diagnosed and treated in time. Reconstructing vital vascular with autograft or artificial vessels, reducing extremity is- chemia time, and administrating routine antithrombotic agents may lower the morbidity rates.