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膝关节周围高能量创伤的肢体挽救

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摘要 目的:探讨高能量外伤致膝关节周围闭合性骨折伴股(腘)动脉损伤诊断及处理原则。方法:本组37例病人分别系膝关节周围如股骨髁上、股骨髁间、胫骨近端骨折伴腘动脉损伤,分别于不同时间探查吻合血管,部分血管缺损2cm以上者采用自体大隐静脉或人工血管移植修复血管。结果:37例患者均获得6个月以上的随访,6例外伤后超过48小时再探查吻合血管者截肢;5例外伤后超过24小时再探查吻合血管者患肢功能大部丧失,其中1例足部坏死行截趾;24例外伤后8小时以内吻合血管者功能恢复良好;2例虽在8小时以内吻合血管,但均系多发伤昏迷患者,继发骨筋膜室挤压综合征导致缺血性肌挛缩,其中1例二期截肢。结论:高能量外伤所致闭合性膝关节周围骨折应高度警惕股(腘)动、静脉损伤,早期明确诊断,尽早恢复肢体血液循环是挽救肢体的关键。
出处 《新疆医学》 2009年第9期26-29,共4页 Xinjiang Medical Journal
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