四肢主干血管急性损伤的诊治

目的 对３０８例四肢主干血管急性损伤进行回顾分析。方法 本组共３０８例，其中开放性损伤１８１例，闭合性损伤１２７例。男２９９例，女９例。年龄最大６２岁，最小６岁，平均２４．５岁。对该种损伤患者尽早施行手术清创、探查。具体修复方法为：（１）单纯修补缝合受损的血管。（２）血管端端吻合术。（３）血管移植。结果 ３例因吻合口血栓形成发现较晚而截肢。１例因肢体血循环重建时间较长，术后出现骨筋膜室综合征肾功能

Diagnosis and Treatment of Acute Vascular Injuries in Limbs

Objective To retrospectively study the results of 308 patients with acute large artery injuries. Methods Three hundred and eight patients with acute large artery injuries were reviewed. The managements were direct suture, end to end anastomosis, and reconstruction by saphenous vein graft. Results Amputation had been done in 5 patients. Three of them were due to late thrombosis in anastomostic stoma; 1 had severe infection highly suspicious of gas gangrene; and 1 had osteofascial compartment syndrome and renal failure. The other 303 patients all had their limbs survived and got good function. Conclusion The surgical exploration should be done as soon as possible when diagnosis of injuries of large arteries is definite or highly suspected. End-to-end anastomosis and venous graft are the procedure of choice. Revascularization of a damaged artery should not be limited by time. Shock more often companies with partial rupture than complete one.