四肢创伤合并重要动脉损伤103例诊治体会

Experiences in diagnosis and treatment of wounds in limbs with complicated artery injuries—103 cases report

目的 :分析我科自 1995年 1月至 2 0 0 1年 1月共收治四肢创伤合并重要动脉损伤患者 10 3例的经验。方法 :早期诊断血管损伤 ,简捷有效的骨科固定 ,应用Fogarty导管取栓 ,正确地处理损伤血管是取得治疗成功的有效措施。采用放射介入技术使用球囊扩张导管阻塞动脉 ,可以明显减少锁骨下动脉等复杂部位探查手术时的出血。结果 :术后肢体血供正常 ,功能良好者 91例 ;肢体部份肌肉缺血性痉挛 ,功能受损者 8例 ;肢体坏死截肢者 3例 ;继发感染休克死亡 1例。结论 :在处理四肢创伤的同时高度警惕重要动脉的损伤 ,及时进行血管探查 ,正确处理损伤血管 ,才可以获得满意的疗效。

Objective:To describe the treatment of wounds in limbs with complicated artery injuries.Method:From January 1995 to January 2001,103 cases of wounds in limbs with complicated artery injuries were treated in our department.While treating them,we had cared of artery injuries,explored blood vessels without delay and treated wounds properly.The article pointed out that the early diagnosis,simple and direct fixation,Fogarty catheter extracting thrombus and proper treatment were effective measures.By means of radio intervention technique,balloon dilation catheter can be used in the treatment of vascular hemostatic preoperative,it was effective in decreasing blood loss of subclavian artery.Result:Good results were achieved in 91 cases without ischemia of the limb.Partial limb ischaemia Caused sparsm were in 8 cases,amputation due to necrosis in 3 cases.One case died of secondary infection shock.Conclusion:It is important to take care about artery injuries of wounded limbs and the wounded arteries must be treated properly. [