84例四肢血管急性损伤的治疗

目的 探讨有关四肢血管损伤的治疗效果。方法 在84例四肢血管损伤中，伤后6－8小时内重建损伤血管38例，8－12小时内重建34例，＞12小时重建12例。骨折采用内固定方式40例，行血管修补缝合20例，端－端吻合36例，静脉移植28例。结果 I期截肢9例，Ⅱ期截肢4例，6例发生缺血性肌挛缩。结论 四肢血管急性损伤的预后主要取决于肢体缺血时间、神经损伤程度、骨折严重程度、软组织损伤程度和其他脏器损伤情况等因素。诊断明确后，或高度怀疑有血管损伤者，应尽早手术探查。

Management of acute vascular injuries of extremities in 84 cases

Objective To explore the effects of treatment of limbs vascular injury.?Methods Eighty four cases of limbs vascular injury were treated.The reconstruction of injuried blood vessels had been taken 6 8 hours after injury in 38 cases,6 12 hours after injury in 34 cases and over 12 hour after injury in 12 cases. Internal fixation was performed.The injuried vessels were mended in 20 cases.End to end anastomoses were performed in 36 cases. Saphenous vein graft were performed in 28 cases.?Results Nine cases had primary amputation,4 cases had a secondary amputation and 6 cases had ischemic muscular spasm.?Conclusion The prognosis of limb vascular injury depends on the length of ischemic period,the severity of neurological injury and fracture,as well as soft tissue damage and the presence of associated major injuries.Surgical exploration should be done as soon as possible after a definite diagnosis.