四肢主干血管损伤的处理(附39例报告)

目的　对 39例主干血管损伤进行回顾分析。　方法　本组共 39例 ,急诊病人 31例 (开放损伤 2 7例占87% ) ,晚期损伤 8例 ,采用血管移植、直接吻合等方式处理。　结果　平均随访 2 0 4个月 ,修复血管通畅率为 92 3 % ,2例因术后血运障碍二次手术无效而二期截肢 ,1例因术中过度失血死亡。　结论　强调早期诊断和早期治疗此类损伤是成功的关键 ,对诊断明确或高度怀疑有血管损伤者应立即手术探查 ,血管端端吻合、血管移植是首选的手术方法。对晚期血管损伤应争取修复血管以改善肢体循环

Management of Vascular Injuries of the Limbs

Objective To retrospectively study the results of 39 patients with vascular injuries of the limbs. Methods Thirty-one cases were acute injuries (27 open injuries,87%) and 8 cases were chronic injuries.The all cases were maneged with vascular graft and anastomosis. Results The mean follow-up period was 20.4 months,the patency rate of the repaired vessels was 92.3%.Amputation was conducted in 2 patients (5.1%). Conclusion Early diagnosis and management according to the clinical manifestations are the key to a successful outcome.Surgical exploration should be done as soon as possible when diagnosis of major vascular injuries is definite or highly suspected.End-to-end anastomosis and venous graft are the procedures of choice.Late vascular injuries with serious ischemic symptoms should be repaired to improve the circulation of the limbs.