彩色多普勒超声在指导周围血管穿刺性损伤治疗中的价值

目的 探讨彩色多普勒超声在指导周围血管穿刺损伤治疗中的价值.方法 对26例外周血管穿刺损伤引起的血肿、假性动脉瘤和动静脉瘘,采用彩色多普勒超声探查损伤的性质、部位、大小和相邻血管的关系及其血流动力学状态,确定治疗方案.结果 彩色多普勒超声确诊单纯血肿3例、假性动脉瘤19例、股动脉-股静脉瘘4例.根据超声提示的病变大小及周围毗邻关系不同选择不同的治疗方案,其中2例血肿行物理治疗,1例血肿因压迫股静脉而行淤血清除术;6例假性动脉瘤在超声引导下行瘤体内凝血酶注射,13例行手术切除及动脉修补术;4例动静脉瘘行瘘口结扎、血管修补术.结论 彩色多普勒超声为周围血管穿刺损伤的治疗提供准确信息.

Color Doppler ultrasound-guided treatment of puncturing injury of peripheral vessels

Objective To evaluate the value of color Doppler ultrasound-guided treatment of puncturing injury of peripheral vessels. Methods The nature, location, size and the dynamic state of blood flow via color Doppler were observed and the treatment plans for the hematoma, pseudoaneurysm and arteriovenous fistula caused by puncturing impairment of peripheral vessels were confirmed. Results Physical therapy was performed on 2 patients with hematoma; Removal operation was done on 1 patient with hematoma which compressed the femoral vein; 6 patients with pseudoaneurysm were treated with thrombin injection under the guidance of color Doppler; Pseudoaneurysmectomy and arteriorrhaphy were done on 13 patients; Fistular ligation and angiorrhaphy were performed on 4 patients with arteriovenous fistula. Conclusions Color Doppler provides accurate informations for the treatment of puncturing impairment of peripheral vessels.