股动脉不全断裂远段长段血栓形成机理临床分析

The mechanism of distal long thrombus caused by partial femoral artery rupture

目的:探讨股动脉不全断裂远段血栓形成的机理及处理方法。方法:回顾分析自2005年1月至2011年1月对4例股动脉不全断裂的患者进行修复救治,均以切除损伤部分直接端对端吻合修复,吻合口修复通血后,肢体远端仍无通血表现,探查发现断端以远形成长条状血栓,堵塞吻合口平面远至几乎整条主干血管管腔,而吻合口处及附近血管段无血栓形成,逐段剖开血管壁,取出血栓,缝合血管壁,血管过血通畅,肢体血供恢复。结果:本组4例皆获治愈,术后患肢血供良好,皮温正常,随访6个月无后遗功能障碍。结论:股动脉不全断裂远段长段血栓在血管吻合前早已形成,手术中如出现远段主干血管长段堵塞现象,决不能放弃,应逐段血管进行探查,直至主干血管通畅,肢体血运恢复。

Objective： To investigate the mechanism of formation and the management of distal long thrombus caused by partial rupture of femoral artery. Methods： 4 cases of femoral artery partial rupture between January 2005 and January 2011 was retrospectively analyzed.All the injured lumen was resected and end to end anastomosis was performed.However,the ischemia of distal limb was still present after the operation.At last,the long strip thrombus was found in the distal lumen of the rupture site and occluded almost entire distal arterial lumen.There was no thrombus at the repair site and in the arterial lumen proximal to the rupture site.The distal artery was dissected and the thrombus was removed.The blood supply to distal limb was restored after the repair of dissected artery. Results： Excellent results were achieved in all 4 cases.The blood supply to distal limb was sufficient and the skin temperature was normal.There was no functional impairment after 6-month follow-up. Conclusion： The distal long thrombus was formed earlier before the repair of artery.The operation should not be given up if the distal main lumen was occluded by thrombus.The occluded artery should be dissected step by step until the main artery was open and the blood supply to the distal limb was restored.