全髋置换并发严重血管损伤

为了探讨全髋关节置换术中发生严重血管损伤的机制及其诊治策略,作者对１９７８年－１９９３年施行全髋置换术的７２１例患者进行了调查,其中发生严重血管损伤者３例,发生率为０．４２％。其中１例为摘除中心型脱位的髋臼假体时,骨水泥团块的锐缘割破髂外静脉;１例为髋臼前半区内安放螺丝钉时气钻打洞刺伤外静脉;另１例为切除关节囊瘢痕组织时切破股动脉。作者对并发严重血管损伤的肌制及临床处理进行了分析和讨论。作者认为,

Severe vascular injuries following total hip replacement

Severe vascular injury following total hip replacement (THR) is very rare. It has an a incidence of 0.25% and poses a serious threat to the involved limb and the patient's life. Vascular structures affected include the external iliac artery and vein, femoral artery and vein. In 721 cases of THR 3 had vascular injuries. The first case sustained the injury of the external iliac vessel which was cut by the sharp edge of bone cement while removing the displaced prosthesis. The second had laceration of the iliac vein while a pneumatic drill was used in the anterion superior acetabulum, and the third had the cut injury of the femoral artery during resection of the capsular scar tissue. The understanding of the mechanisms and location of vascular injury during THR will help surgeons in early diagnosis and treatment of the injury.