肱动脉损伤修复的临床研究

Clinical study of brachial artery injuries

目的分析肱动脉损伤的特征、诊断及治疗。方法对本院1988年4月至2003年6月收治确诊的肱动脉损伤患者53例进行回顾性分析,所有病例均为开放性损伤,其中锐器伤占58.5%,挫伤占41.5%。所有病例均合并有骨折、神经损伤或软组织的挫伤。有38例损伤的血管行断断吻合,14例行自体静脉移植,2例行截肢术,1例行单纯取栓术。结果所有病例均随访1-3年,其中1例遗留前臂缺血性肌挛缩,经3次松解及功能重建手术,功能好转,3例肘关节活动受限,其余功能良好,所有患者无死亡。结论肱动脉损伤是比较常见的一种损伤,对前臂和手的功能影响较大,早期诊断,及时治疗可有效保存肢体,进一步减低致残率。

Objective To analyze the features, diagnosis and treatment of brachial artery injuries. Methods A total of 53 patients with brachial artery injury admitted in our department from Apr 1998 to Jun 2003 were analyzed retrospectively in this article. All cases were open injury. The involved vessels were transected in 58.5% of the cases and contused in 41.5%. All the patients hadvarious complications,such as fractures, nerve injury and severe soft tissue injuries. The injured vessels were repaired by means of end-to-end anastomosis in 38 cases,autogenous vein graft in 14 cases,amputationsin 2 cases and embolectomy in lcase. Results All cases were followed up for 1-3 years, 1 case was ischemia muscle contracturre, but the function improved by 3 solution and function reconstruction operation. 3 cases joint motion were limited, the excess cases were good, there was no death in this series. Conclusion The injury of brachial artery is rather hackneyed, the influence to foream and hand is comparatively large. The pristine diagnosis and prompt treatment can save limbs and reduce the rate of muhiation.