闭合性腘动脉损伤11例

Eleven Cases of Closed Popliteal Artery Trauma

目的 :总结闭合性动脉损伤的诊治经验。方法 :1983～ 2 0 0 0年共 11例闭合性动脉损伤患者。肢体血循环重建时间最短 3.5h ,最长 2 7h ,平均 9h。结果 :8h以内重建血循环 5例肢体循环功能恢复功能 ,8～ 10h 2例遗有小腿缺血性挛缩 ,超过 10h 4例中有 1例小腿肌肉坏死 ,3例截肢。截肢率为 2 7% ,总病残率达 5 5 %。结论 :动脉损伤应在 6～ 8h内进行修复 ,超过这一时限病残率及截肢率均明显上升。

Objective: To summarize the experience in treatment and diagnosis of 11 cases of closed popliteal artery trauma and to determine the factors for amputation. Methods: Eleven patients with closed popliteal artery trauma were included from 1983 to 2000 in this paper. Their age was a mean of 40.3 years. The management of the injured popliteal artery were end to end anastomosis, reconstruction by saphenous vein graft and direct suture. Seven popliteal veins were repaired at the same time. The time of the revascularization of the leg was a mean of 9 hours (3.5 27 hours). Results: Amputation had been done in 3 of 4 cases who were sent to hospital too late, the time of revascularization was more than 10 hours, the longest was 27 hours, the other one suffered from muscular necrosis. Two patients with ischemia muscular contracture in the legs were duo to the revascularization during 8 10 hours. Five patients had satisfactory function because their limbs obtained blood in 8 hours. The rate of amputation is 27% in these cases. Conclustions: The popliteal artery trauma should be treated as soon as the diagnosis was made. If the revascularization is more than 8 hours, it will affect the leg survival. Delayed diagnosis is the cause of higher rate of amputation in the closed popliteal artery trauma.