四肢主要动脉损伤诊治体会

目的 探讨四肢主要动脉损伤的早期诊断方法和治疗效果。方法 对1991年1月～2003年10月36例四肢主要动脉损伤患者，分别采用端端吻合、血管修补、自体大隐静脉移植、残端结扎等方式修复损伤血管。结果1例血管吻合重建血循环后因肢体损伤严重，广泛坏死而截肢，其余35例全部存活。结论 ①早期诊断是肢体抢救成活的关键，诊断明确或疑有血管损伤者应尽早手术探查；②血管修补缝合术，血管端端吻合术是主要修复方法，血管缺损2cm以上者应行自体静脉移植术；③动脉血管修复的时限可根据伤情及全身情况适当延长。

Diagnosis and treatment of lesions of major limb arteries:a report of 36 patients

Objective To discuss our experience in diagnosis and treatment of lesions of major l imb ar-teries.Methods 36patients with lesions of major lim b arteries were treated from January1991to October 2003in our department.The injured arterie s were divided into 4types and repair ed by end-to-end anastomosis,arterioplasty,ligation,and autograft of great sap henous vein.Results The repaired arteries survived in 35patients,but a pa-tient with severe limb injury had to e xperience amputation because of wid e necrosis after reconstruction of blood cir-culation.Conclusions Carefully monitoring ischemia sign s of the traumatized limb is very important to the diagnosis of arterial lesions.Exploration sh ould be made in time when the diagnosis is definite or arterial lesions are suspected.The main treatments are repair and en d-to-end anastomosis of blood vesse ls.Autograft of veins should be adop ted if the defects of blood vessels are over2cm.The time limit for arterial repair may be extended according to the se verity of injury or systemic conditions.