21例刀枪伤累及血管损伤的诊治

目的 根据刀枪伤所致血管损伤的特点，探讨其诊断和治疗的特殊性。方法 21例因刀枪伤造成血管损伤的病例，均行急诊手术治疗，并行血管修复。结果 21例术前能明确诊断合并血管损伤的仅14例。全部病人均予急诊手术。1例因颈内动脉断裂死亡，另1例术后3d因多脏器功能衰竭死亡；13例血管重建，2例仅结扎断端血管。患者术后恢复顺利，无功能障碍。2例患者分别于损伤后6、8年发现存在血管损伤，予血管腔内修复术。结论 刀枪伤入口小，单一的创口可造成多处的深部损伤；合并伤的严重程度和术前血管损伤的明确诊断，对评估患者的手术预后有着重要的意义。

Diagnosis and Treatment of Vascular Injuries Caused by Knife and Gun Trauma in 21 Cases

Purpose To report clinical experience in diagnosis and treatment of peripheral vascular trauma in Shanghai Zhongshan Hospital and Macao Centro Hospitalar Condo de Sao Januario. Methods Twenty-one cases of vascular injure caused by knife and gun trauma were analyzed from 1997 to 2000 in this study. There are 16 male and 5 female patients, the age from 19 - 51 years old(mean 30. 87). The surgical manage-ment was selected according to the type of vascular injure. Results Auto vessel graft was performed in 20 cases with artificial vessels in 7 cases,anastomsis on 67,ligation on 19,and repair on 23,and thrombectomy on 2. Amputation was performed in 2 cases. Two cases were died during the treatment period. Conclusions The early diagnosis of vascular injure is very important. The correct diagnosis and prompt surgical manage-ment can decrease the rate of amputation and save the life.