四肢主要动脉损伤34例的早期诊断及治疗

Early diagnosis and treatment of main artery injuries of limbs:A report of 34 cases.

目的 :探讨四肢主要动脉损伤的早期诊断方法和治疗效果。方法 :对 34例四肢主要动脉损伤病例早期确诊并手术探查修复 ,血管修复的方法有血管修补缝合术、端端吻合术和自体静脉移植术。结果 :1例血管吻合重建血循环后因肢体损伤严重、广泛坏死而截肢 ,其余 33例全部存活。结论 :(1 )四肢主要动脉损伤诊断明确或疑有血管损伤者应尽早手术探查 ;(2 )血管修补缝合术、血管端端吻合术是主要修复方法 ,血管缺损 2cm以上者应行自体静脉移植术 ;(3)动脉血管修复的时限可据伤情及全身情况适当延长。

Objective:To discuss the early diagnosis method and curative effect of main artery injuries of limbs.Methods:Thirty-four cases of main artery injuries of limbs were diagnosed in early stage,and were treated with exploration and renovation including repair and suture operation of blood vessel,end to end anastomosis and autotransplantation of venae.Results:Thirty-three cases were survival,a case of severe injuries of limbs was amputated because of wide necrosis after blood vessel anastomosis.Conclusions:(1)Exploration should be made in time if the diagnosis is clear or suspicious.(2)The main renovations are repair and suture operation of blood vessel and end to end anastomosis,autotransplantation of venae should be adopted if the defects of blood vessels are over 2 cm.(3)The time limit of arterial renovation may be extended according to injury condidtion and systemic condition.