上肢主要动脉损伤的显微外科修复

目的　总结上肢主要动脉损伤 2 16例治疗的临床经验 ;方法　血管损伤后主要修复方法为 :( 1)单纯修补缝合受损的血管 ;( 2 )血管端端吻合术 ;( 3)血管移植。结果　本组 2 16例 ,有 5例术后吻合口血栓形成 ,其中 2例发现及时 ,经再次手术 ,肢体存活 ;3例术后因发现较晚而截肢 ,余 2 13例全部存活。结论　 ( 1)诊断明确后或高度怀疑有血管损伤者 ,应尽早行手术探查 ;( 2 )肢体血循环重建的时限 ,可根据伤情、技术能力等适当延长 ;( 3)血管端端吻合及血管移植是首选的手术方法 ;( 4 )尺、桡动脉同时损伤者 ,强调两条动脉均应修复。

Microsurgical Repair of Major Vascluar Injuries of the Upper Ext remity

Objective: To present the experiences on 216 patients with major vascular injuries of the upper extremities. Methods: Revascularization methods included primary repair, resection and end to end anastomosis and resection with an interposition graft. Results: 5 cases had postoperative thrombosis after reconstruction. 3 cases received amputation. The other 213 patients had their upper extremities survived. Conclusions: The surgical exploration should be done as soon as possible when the diagnosis of major vascular injuries was obtained or suspected highly. End to end anastomosis and venous graft should be preceding choices. Revascularization of damaged artery should not be limited by time and might be done in reasonable extend time according to trauma and conditions. The radial and ulnar artery injuries should be repaired together when both are damaged.