颈外静脉修复重建股动脉的临床应用

目的 介绍应用颈外静脉移植修复重建股动脉的临床效果。方法 2002年6月～2006年4月。对22例因注射毒品所致的假性股动脉瘤手术切除后致股动脉缺损患者。应用颈外静脉移植修复晕建。其中男20例。女2例；年龄25～46岁，平均31．2岁。股动脉缺损5～9cm。平均6．8cm。左侧14例。右侧8例。结果 术后伤口Ⅰ期愈合10例，Ⅱ期愈合4例。余8例伤口裂开并溃疡形成。二次手术行局部皮瓣移位修复，创面愈合。除1例因吻合口破裂出血而最终结扎股动脉外。其余均成功重建股动脉缺损。足背动脉均可扪及搏动。18例获1～30个月随访。动脉瘤无复发。12例复查彩色多普勒显示移植的颈外静脉已动脉化，并替代原缺损股动脉。结论 颈外静脉解剖恒定且表浅。切取容易。口径接近于股动脉，可作为自体静脉移植材料修复重建股动脉。手术操作简便。疗效确切。有一定的临床府用价值。

RECONSTRUCTION OF FEMORAL ARTERY WITH EXTERNAL JUGULAR VEIN GRAFT

Objective To introduce the treatment and clinical result of reconstructing femoral artery with external jugular vein graft.Methods From June 2002 to April 2006,22 cases of femoral artery defects caused by pseudoaneurysm resection,were reconstructed with external jugular vein graft by microsurgical technique.There were 20 males and 2 females,aging 25-46 years(mean 31.2 years).The length of femoral artery defects was 5-9 cm,with an average of 6.8 cm.The location was left in 14 cases and right in 8 cases.Results Ten cases achieved healing by the first intention,and 4 cases by the second intention.The other 8 cases need the regional flap repair because the wound splited open and became ulcer.Femoral artery defects were reconstructed successfully and the pulse of dorsal arteries of foot could be felt except 1 case of bleeding of anastomotic rupture.Eighteen patients were followed up 1-30 months,and no pseudoaneurysm recurred.Color ultrasound Doppler detection showed that the external jugular veins took place of the femoral artery defects in 12 cases.Conclusion External jugular vein is stable at anatomy and easy-to-obtain.Its calibre is close to that of the femoral artery.It can be used for reconstructing femoral artery defects as the vein material.The operation is easy and the clinical result is sure.