注射毒品所致假性股动脉瘤18例的外科治疗

Surgical management of femoral artery false aneurysm due to addictive drugs injection

目的探讨注射毒品所致假性股动脉瘤的外科疗法。方法对 18例注射毒品所致假性股动脉瘤患者的临床资料进行回顾分析。 13例直接采用ePTFE人工血管行旁路髂外动脉和股浅动脉端侧吻合术 ;3例采用自体大隐静脉间置移植术 ,其中 1例术后吻合口破裂出血改用ePTFE人工血管行旁路髂外动脉和股浅端侧吻合术 ;2例股动脉结扎术。结果全部病例保肢成功。血管移植者术后复查彩色多普勒超声显示移植血管通畅。结论在患者不能提供合适的自体大隐静脉移植时 ,人工血管移植仍是治疗假性股动脉瘤的有效方法。

ObjectiveTo evaluate surgical management of femoral pseudoaneurysm caused by injection of addictive drugs.MethedsData of 18 cases were reviewed and analysed retrospectively.13 patients underwent primary expanded polytetrafluoroethylene(ePTFE) external iliofemoral bypass (end to side) grafting. Postoperative anastomotic burst and bleeding in one of the 3 patients undergoing saphenous vein autotransplant in situ was successfully treated by ePTFE grafting. Results All of the grafts were patent as demonstrated by postoperative color Dopler ultrasonography. Although 2 patients had their femoral arteries ligated, limbs of all the 18 patients were salvaged.ConclusionsWhen a suitable saphenous vein is not available for autotransplantation, an artificial vessel grafting is still an effective procedure for managing femoral artery false aneurysm.During operation thorough debridement and avoidance of artificial vessel contamination are the most important factors for preventing infective complications of the graft.