儿童外伤性动静脉瘘的诊断与手术治疗

Diagnosis and treatment of traumatic arteriovenous fistula in children

目的：探讨儿童外伤性动静脉瘘的诊断与治疗方法。方法回顾性分析2011年1月至2014年7月我们收治的24例外伤性动静脉瘘患儿临床资料，男13例、女11例，年龄2～8岁。病变发生于上肢6例，下肢16例，颈部2例。对全部患儿行血管多普勒超声、CTA 检查。22例管状型动静脉瘘行单纯瘘管结扎术，2例肢体末端囊瘤型动静脉瘘行动静脉瘘切除术。结果24例术后均未出现血管神经损伤，肌张力正常，患肢或颜面部无肿胀，术后随访1个月至3年，无复发。结论对儿童外伤性动静脉瘘宜早期诊断，一旦确诊应立即手术，以彻底治愈，若已经出现并发症，应先彻底关闭瘘口，再治疗并发症。

Objetive To explore the diagnosis and treatment of traumatic arteriovenous fistula （AVF） in children.Methods A retrospective analysis was made on clinical data of 24 patients with traumatic arterio-venous fistula （AVF）treated in our hospital from Jan.2011 to Jul.2014.There were 13 male and 11 female cases with their ages ranging from 2 to 8.The lesions were located in upper limbs in 6 cases,in lower extremi-ties in 16 cases,in neck in 2 cases.All patients underwent Color Doppler ultrasonography and CTA.22 cases of tubular arteriovenous fistula underwent fistula ligation.2 cases of cystic arteriovenous fistula underwent fistu-lectomy.Results All patients underwent operation successfully.No swelling of limbs,alterations in muscle tone,manifestations of vascular and nerve injury,disorder of sensation and movement happened after the opera-tion.During 1 month to 3 years follow-up,no recurrence was found. Conclusions Patients who diagnosed with traumatic arteriovenous fistula must be treated as early as possible to cure lesions.If patients already had complications,they should be treated with radical operation to close the fistula,and then the development of complications should be controlled.