四肢主干动脉闭合性损伤

Closed Injuries of Artery in Limbs

目的 对 31例四肢主干动脉闭合性损伤进行回顾性分析。方法 本组共 31例 ,男 30例 ,女 1例 ,年龄最大 5 2岁 ,最小 17岁 ,平均 2 7.3岁。对该种损伤尽早施行手术探查 ,重建肢体血运。具体修复方法 :1单纯修补缝合 ;2血管端端吻合 ;3自体血管移植 ;4异体血管移植。结果 2例因早期漏诊肢体血循重建时间长而截肢 ,1例血循重建术后感染而截肢 ,1例死于术后顽固性休克 ,余 2 7例肢体完全成活。结论 1闭合性四肢主干动脉损伤早期易漏诊 ;2诊断明确或高度怀疑有血管损伤应尽早手术探查 ;3显微外科技术无张力吻合是修复成功的关键。

Objective To retrospectively study the results of 31 patients with closed large artery injuies in limbs.Methods Thirty-one patients with closed large artery injuries were reviewed.The managements were direct suture,end and end anastomosis,reconstruction by saphenous vein graft,and reconstruction by allograft of artery.Results Amputation had been done in 3 patients.Two of them were due to be neglected at the initial stage;and 1 had severe infection.One patient had died because of shock.The other 27 patients all had their limbs survived and got good function.Conclusions Closed large artery injuries may easily be neglected at the initial stage.Surgical exploration should be done as soon as possible when diagnosis of injuries of large arteries in definite or highly suspected.The roles of microsurgery are very important poins for successful operation.