感染性假性动脉瘤血管处理方式的选择

Choosing suitable model of vascular management to infected femoral pseudoaneurysm from drug abusers

目的探讨对于注射吸毒导致的感染性假性动脉瘤血管手术方式的选择。方法对我院2005年8月~2008年2月收治的17例注射吸毒导致的假性动脉瘤患者进行总结。全部患者均行手术治疗,血管处理的方法有：8例行人工血管旁路转流,4例自体大隐静脉原位转流,1例动脉修补,4例股动脉结扎。结果17例中有1例死亡。1例术后并发动脉吻合口瘘,再次手术修复吻合口成功。术后随访15例：人工血管阻塞2例,其中有1例出现下肢缺血症状。动脉结扎的病例有1例手术后2月出现下肢坏死而截肢。至少6例在术后出现毒品复吸。结论注射吸毒所致的感染性假性动脉瘤的血管处理须依据多种因素综合判断而定,总体疗效满意。

Objective To study the suitable model of vascular management to injected femoral pseudoaneurysm with drug addicts.Methods We summarized 17 cases of femoral pseudoaneurysm caused by injected drug abuse from Aug 2005 to Feb 2008 in our hospital.All patients were operation.Eight were vascular reconstructed using extra-anatomic bypass by polytetrafluoroethylene（PTFE） graft and four by great saphenous vein graft.One was repaired the ruptured artery.Four were simple ligation of the femoral artery.Results One was death from hemaorrhage.Another was complicated with anastomotic fistula and bleeding,and then repeatedly operated.Fifteen were in follow-up.Two grafts occluded and one had ischemia symptoms.One case with ligated artery was amputated in two months post-operative.Recidivism and continued abuse was the consequence in six patients in follow-up.Conclusion The management of femoral pseudoaneurysm with injected drug abuse was determined by a number of factors.The prognosis was good.