创伤性假性动脉瘤和动静脉瘘的手术治疗

目的 探讨创伤性假性动脉瘤（pseudoaneurysm,PsAn)和创伤性动静脉瘘（arterio-venous fistula,AVF)的手术方法及其疗效。方法 回顾性分析1989年1月-2001年2月经手术治疗的PsAn及AVF共43例，根据分型分别采用单纯或四头结扎术10例；经瘤腔破裂口修补术13例；单纯血管移植5例；经动脉切开修补瘘口，重建动脉血流8例；经静脉切开修补瘘口，静脉结扎或切除3例；经瘤腔同时修补动静脉瘘口1例；瘘切断或切除，动静脉壁瘘口侧面修补术1例，经瘤腔修补静脉瘘口，动脉结扎或血管移植2例。结果 死亡2例，余41例近期疗效满意，随访34例，2例AVF肢端慢性溃疡者效果欠佳。余32例效果良好。结论 对创伤性PsAn和AVF应早期手术。根据分型采用不同手术方法，效果良好。

Surgical treatment of posttraumatic pseudoaneurysms and arteriovenous fistulas

Objective To investigate the effect of surgical therapy for post traumatic pseudoaneurysm and arteriovenous fistulas. Methods Forty three patients with traumatic pseudoaneurysm and arteriovenous fistulas from January 1989 to February 2001 were retrospectively reviewed. Simple or quadrate ligation was performed on 10 cases, lateral suture on 13 cases, vessel graft interposition alone on 5 cases, transartery defect suture and restoration of the arterial flow on 8 cases, transvein defect suture on 3 cases, transaneurysm arteriovenous defect suture on 1 case, division of the fistula and lateral suture on 1 case, transaneurysm venous defect suture and artery ligation or vessel graft interposition on 2 cases. Results Two patients died and 34 patients were followed up, in whom 32 patients got the expected effect except two with chronic ulcer in extremities. Conclusions Surgical treatment should be performed on these patients at early stage. The method of surgical intervention should be varied according to different types of injuries.