周围假性动脉瘤的外科治疗

Surgical treatment of peripheral pseudoaneurysm

目的 评价周围假性动脉瘤外科治疗的方法及其疗效。方法 总结1957 年8 月～1997 年8 月收治的周围假性动脉瘤64 例,手术方式包括:瘤体切除+ 动脉结扎21 例;瘤体切除+ 动脉破口修补28 例;瘤体切除+ 动脉端端吻合6 例;瘤体切除+ 血管移植9 例( 移植血管包括自体大隐静脉5 例,人造血管4 例) 。8 例合并动静脉瘘同时行静脉修补(1 例合并静脉瘘行股静脉人造血管移植) 。结果 55 例获随访,其中51 例效果满意,另4 例遗有不同程度的肢体远端缺血症状。结论 周围假性动脉瘤的诊断首选彩色B 超,必要时选用血管造影;

Objective To evaluate the therapeutic effect of surgical treatment for peripheral pseudoaneurysm(PPA). Methods Abstract Objective To evaluate the therapeutic effect of surgical treatment for peripheral pseudoaneurysm(PPA). Methods From August 1957 to August 1997, 64 patients with PPA were treated with surgery. The surgical techniques include: (1) aneurysmectomy and artery ligation for 21 patients with a single pseudoaneurysm of the radial or tibial arteries; (2) aneurysmectomy and lacerative repair for 28 cases; (3) aneurysmectomy and arterial end to end anastomosis or vascular grafting for 15 cases (grafts include autogenous saphenous vein, artifical blood vessel and so on); (4) 8 cases accompanied with arteriovenous fistula were operated synchronously with vein repair. Results The results were excellent in 44 of 52 patients with a follow up period of 0.5～18 years. There were varied symptoms of ischemia or less perfusion at the distal part of extremities in other 4 of 55 patients. Conclusions Once the diagnosis of PPA is mede, the surgical treatment is necessary to prevent rupture. Ultrasonic examination is the first choice for diagnosis; but arterography should be taken if nectssary. Surgery treatment shows good effect.