延误诊治的下肢大血管损伤的临床救治

目的　总结延误诊治的下肢大血管损伤的救治经验和教训。方法　对本组延误诊治的 1 7例病例均行小腿骨筋膜室切开 ,并根据不同情况分别行对侧大隐静脉移植修复血管 8例 ,血管吻合 3例 ,血管结扎 6例。本组 1 7例中 ,Whitman功能分级为好 5例 ;6例下肢功能于术后 8～ 1 2个月恢复 ;截肢 6例。结论强调血管损伤的早期诊治 ,若基层医院无血管修复条件 ,早期行小腿骨筋膜室切开减压 ,及时转送上级医院。强调修复下肢大静脉的必要性。小腿肌肉缺血是决定修复动脉或是果断截肢的主要依据之一。

Delayed diagnosis and treatment of vascular injuries in lower limbs

Objective To sum up the experience in the diagnosis and treatment of delayed vasculayed injuries in lower limbs in 17 cases. Methods The clinincal data of 17 cases were analyzed in the sutdy. Operative decompression was performed in all compartments of those legs,and which were treated by different methods. Results Auto-saphenous vein graft was performed in 8 cases,anastomosis of the injuryed vessels in 3 cases,ligation in 6 cases,amputation was performed on 6 cases. Conclusion Vascular injury of the lower limb needs early diagnosis and treatment,if grass roots hospital having no condition for vascular operative treatment,operative decompression of all compartment of the leg should be perfromed early. Repair of the great vein injury of the lower limb is necessary. Vascular repair or amputation depcnds on the condition of necrotic muscles.