四肢真性动脉瘤的诊治

Management of true extremity aneurysms: experience in 23 patients

目的探讨四肢真性动脉瘤的病因及诊断和治疗的特殊性。方法回顾性分析我院１９８４年１月～１９９７年９月收治的２３例四肢真性动脉瘤患者的临床资料。结果本组２３例患者共有肢体动脉瘤３０个，其中７例为多发性动脉瘤，占本组患者的３０４％。２１例患者行动脉瘤切除、自体大隐静脉或人造血管移植术。结论对四肢动脉瘤应早期诊断和治疗，防止危害肢体的并发症，并密切注意多发性动脉瘤的可能。治疗上首选动脉瘤切除自体大隐静脉移植术，术后注意随访。

Objective To explore the etiologic feature and specificity of diagnosis and treatment in true aneurysms of the extremities. Method 23 patients with true aneurysms of the extremities from January 1984 to September 1997 were retrospectively reviewed. Result Of 30 true aneurysms of the extremities, multiple aneurysms were found in 7 patients (304%) .The multiple aneurysms were diagnosed in the same time or in different time. 21 patients were treated by exclusion of aneurysm and replacement with autogenous saphenous vein or graft. Conclusion Early diagnosis and treatment are recommended to prevent complications which can cause limb loss,and multiple aneurysms must be taken into account. Importance of arteriography should be stressed in the diagnosis of multiple aneurysms. Exclusion of aneurysm and autogenous saphenous vein reconstruction is the first choice of treatment, circulation of the operated extremities should be noticed and close followup is imperative to pay attention to the development of new aneurysms. 