创伤性动静脉瘘20例的手术治疗

目的：探讨创伤性动静脉瘘(arteriovenous fistula,AVF)的手术方法。方法：回顾性分析了：1989年1月至2001年8月经手术治疗的创伤性AVF20例，共23个动静脉瘘。分别采用四头结扎术2例；经静脉切开修补瘘口3例；经动脉切开修补瘘口、重建动脉血流8例；瘘切断、动静脉壁瘘口侧面修补术1例；经瘤腔同时修补动静脉瘘口1例；经瘤腔修补静脉瘘口、动脉结扎或大隐静脉移植2例；瘘管结扎术3例。结果：死亡1例，随访16例，2例复发，2例肢端慢性溃疡者效果欠佳，余效果良好。结论：创伤性AVF应早期手术，根据分型采用不同手术方法，效果良好。

The surgical treatment of post-traumatic arterio-venous fistulas

ObjectiveTo evaluate a variety of surgical therapies of post-traumatic arterio-venous fistulas(AVF).Methods Twenty patients with traumatic AVF were admitted from January 1989 to August 2001 with 23 AVFs . Quadrate ligation was performed in 2 cases, transvenous fistula suture in 3 cases, transartery defect suture plus restoration of the arterial blood flow in 8 cases, division of the fistula plus A.V defect lateral repair in 1 case, transaneurysm A.V defect repair in 1 case, transaneurysm venous defect repair and ligation of the artery or saphenous vein graft interposition in 2 cases, and simple fistula ligation in 3 cases.ResultsIn this series one patient died, 16 patients were followed-up, most patients were doing well except for two with chronic ulcer in extremities and 2 suffering from recurrent fistula.ConclusionTraumatic AVF patients should undergo surgical treatmant as early as possible. The modality of surgical therapy should be individualized.