股动脉结扎术治疗吸毒者股动脉假性动脉瘤32例

Femoral artery Hgation for the treatment of femoral artery pseudoaneurysm secondary to drug injection

目的探讨股动脉结扎术治疗吸毒者股动脉假性动脉瘤的疗效。方法回顾性分析2003年1月至2010年3月采用股动脉结扎术＋局部清创术治疗32例吸毒者股动脉假性动脉瘤的临床资料，术后3、6,9、12个月进行随访，采用肢体末梢氧饱和度及其运动功能评价患肢血供。结果32例患者手术均获得成功。术后患肢末梢氧饱和度较术前无明显改变（95．1％±2．8％比96．9％±1．9％；t=1．26，P=0．25），出院血白细胞计数及中性粒细胞百分比较入院明显下降。随访期为1年，随访率为100％；1例术后6h出现缺血表现而行自体大隐静脉髂股旁路转流术，术后恢复良好；术后3个月内5例轻度间歇性跛行；术后6个月仅2例轻度间歇性跛行；术后9个月所有病例间歇性跛行症状基本消失；所有患者均能维持正常生活。结论股动脉结扎术为治疗吸毒者股动脉假性动脉瘤为一种安全、有效和简单的方法。

Objective To evaluate femoral artery ligation for femoral artery pseudoaneurysm secondary to drug injection. Methods Clinical data of 32 drug addicts of femoral artery pseudoaneursysm caused by drug injection undergoing femoral artery ligation and local debridement were reviewed retrospectively. The blood supply of affected limb was evaluated by oxygen saturation of distal limb and its function. All the cases were followed up at 3,6,9,and 12months after the operation. Results Surgery was successful in all cases. There were no significantly difference of the limb oxygen saturation between postoperative and preoperative period （95. 1% ±2. 8% vs. 96. 9% ± 1.9% ;t = 1.26,P =0. 25）. White blood cells and neutrophils percentage significantly decreased after surgery. All patients were followed up for 1 year. Lower extremity ischemia after 6 hours of operation in one case treated by autologous saphenous vein bypass recovered. On 3 months mild elaudieation was observed in 5 cases. On 6 months claudieation remained in only 2 eases, which disappeared on 9 months. All patients were able to maintain normal life. Conclusions Femoral artery ligation is a safe, effective and simple treatment modality for femoral pseudoaneurysms secondary to drug injection.