注射海络因所致感染性假性股动脉瘤的外科治疗

Surgical treatment of the infected femoral pseudoaneurysm caused by injection of heroin

目的 探讨注射海络因所致感染性假性股动脉瘤的外科治疗方法。方法 对 14例注射海络因所致感染性假性股动脉瘤患者的临床资料进行回顾性分析。结果 14例患者均行手术治疗 ,术中见股动脉破裂口长 0 .5～ 2 .0cm ,皆予以瘤体切除 ,人工血管髂股动脉置换术 ,全组术后肢体供血良好 ,功能正常 ,瘤腔和创口经清创、引流和抗感染治疗后均愈合。术后 2周及 3个月彩超复查示移植血管通畅 ,未发现吻合口漏或血栓形成。结论 瘤体的彻底清创和血管重建是治疗注射海络因所致感染性假性股动脉瘤的有效方法。术后应注意瘤腔的充分引流。

Objective To investigate the surgical treatment of infected femoral pseudoaneurysm caused by injection of heroin. Method Retrospective analysis was made on the clinical data of 14 cases of infected ruptured femoral pseudoaneurysm caused by injection of heroin. Results All 14 cases underwent operation. The ruptured sizes of arteries were 0.5 cm-2.0 cm . All cases were treated by resection of the aneurysm and replacement of iliac-femoral artery with artificial graft. Blood supply and function were good in all limbs after operations. Aneurysm cavities and incision wounds were treated with debridement, drainage and anti-infective treatment. All wounds were healed. 2 weeks and 3 months after operation, the grafts were patency demonstrated by Color Doppler examination. None of them was complicated with anastomosis leakage or thrombosis. Conclusion Thorough debridement of aneurysms and reconstruction of the artery are the effective approach in treating the infected ruptured femoral pseudoaneurysm caused by injecting heroin. Sufficient drainage, anti-infective and anti-coagulation therapy should be considered after the operation.