177例四肢主要血管损伤的救治

目的 对177例四肢主要血管损伤的救治进行回顾性分析。方法 1989-2000年救治四肢主要血管损伤177例，其中男137例，女40例：年龄1.2-65岁，平均36.4岁，全组手术清创和探查后，针对不同的情况选择血管修复方法。结果 采用自体静脉或人造血管移植38例（21.5%)，血管吻合85例（48.0%)，血管修补21例（11.9%)，血管结扎30例（16.9%)，介入栓塞3例（1.7%)，死亡4例（2.3%)，肾功能衰竭4例（2.3%)，截肢23例（13.0%)。结论 四肢主要例（1.7%)，死亡4例（2.3%)，肾功能衰竭4例（2.3%)，截肢23例（13.0%)。结论 四肢主要血管损伤救治原则是生命第一、肢体第二；快速诊断，快速救治是前提；快速止血是重点；强调对深静脉的修复并正确处理感染性血管损伤。

Diagnosis and treatment of major vascular injuries in extremities in 177 cases

Objective To retrospectively study the results of 177 cases of major vascular injuries in extremities from 1989 to 2000 in our department. Methods There were 137 male and 40 female patients, the age yanging from 1 4 /12 to 65 years old (mean 36.4). The management was selected according to the type of vascular injuries. Results Auto vein or artificial blood vessel graft was performed on 38 cases, anastomosis on 85, direct suture on 21, ligation on 30, and intervention embolism on 3. Four cases died during the treatment. Kidney function failure occurred in 4 cases. Amputation was performed in 23 cases. Conclusions The principle of the management of major vascular injuries is life first and extremities second. The most important thing is correct diagnosis and prompt hemostasis. The repair of the depth vein injuries and the infected vascular injuries is also emphasized.