高危吸毒患者假性股动脉瘤的防护及治疗

Prevention and treatment of femoral pseudoaneurysm due to high-risk addictive drug injection

目的探讨注射吸毒引致假性股动脉瘤的特点、传染病防护及外科治疗。方法对34例因注射吸毒导致假性股动脉瘤患者的治疗进行回顾性分析:先行急诊外科处理(加压包扎及支持疗法),完善术前准备及防护后行手术重建患肢血运。结果全部患者手术成功,患肢血运明显改善。术后彩色多普勒超声显示股动脉通畅,血管腔无明显狭窄。术后有2例出现创面愈合不良,人造血管外露,经换药及保守治疗半年后,1例伤口2期愈合,1例行人造血管取出术,术后创面愈合好。结论术前应详细检查患者是否合并传染性疾病并合理防护,可加强医护人员工作的安全性,并对术后患者的治疗提供相应的指导;彻底清创、止血、肢体血运的重建,是假性股动脉瘤治疗的关键。

Objectives To investigate the characteristics, protection and surgical treatment of femoral pseudoaneurysm due to injecting addictive drugs. Methods Data of 34 cases with femoral pseudoaneurysm due to injecting addictive drugs were reviewed and analyzed retrospectively. First, the emergency surgical treatment was conducted. After preoperative preparation and protection were improved, all the patients underwent surgery. Results All the patients had a successful surgery and the limb blood supply was significantly improved. All of the grafts were free-flowing postoperatively as demonstrated by color Doppler uhrasonography, without significant vessel lumen obstruction. In 2 cases, 1 patient＇s wound was not healing, and the other＇s artificial blood vessel was exposed after the surgery. After six months of careful treatment, the wound healed in 1 case, and the artificial vessel was removed in the other, whose wound healed postoperatively. Conclusions Before surgery, we should carefully check all the patients to make sure whether infectious diseases are combined and take reasonable protection accordingly, which can strengthen the security of the medical staff and provide appropriate guidance to postoperative treatment. Debridement, hemostasis and blood supply redevelopment are the keys to the treatment of femoral pseudoaneurysm.