自体静脉移植修复四肢陈旧性动脉损伤

目的 探索动脉损伤距修复时间的长短对血管通畅率、末梢血循环及功能的影响,为陈旧性动脉损伤的临床修复提供依据.方法 在自体静脉移植修复家兔陈旧性动脉损伤的实验研究的基础上,1995年4月～1997年12月采用自体大隐静脉修复陈旧性动脉损伤16例,按损伤时间组(<3个月与>3个月)分期随访检测.结果 本组病例通畅率100%,总有效率91.57%,其中痊愈率78.31%.经统计学处理,修复后远端皮温的恢复、血流量的改善、血流阻力指数(RI)及疗效对比,<3个月组显著优于>3个月组(P<0.01).其改善程度梯度:肱动脉>尺动脉>挠动脉.结论 动脉损伤距修复时间的长短对血管通畅率不构成影响,对远端血循环及功能与结构的改善有明显影响.陈旧性动脉损伤的修复应尽早(力争3个月内)进行,以达到功能与结构的满意恢复,其中肱动脉、尺动脉的修复尤为重要.

Repair The Old Arterial Injury in The Extremities by Autologous Venous Transplantation

ve To investigate the influence of the interval between arterial injuries and autologous venous rapair to the patency rate of the vessels, and the recovery of the blood circulation and the function in the distal end and to provide the clinical basis to repair the old arterial injuries. Methods On the basis of repairing old arterial injuries by autologous venous in rabbit model, from April 1995 to December 1997, 16 cases of the old arterial injuries were repaired by autologous the great saphenous venous transplantation and followed-up respectively over 3 months according to the groups of different interval between the injury and repair ( < 3 months and > 3months). Results Among 16 cases of old arterial injuries after repaired, the overall patency rate was 100%, the overall effective rate was 91.57% and the cure rate was 78.31%. The results showed that it had obvious improvement of the skin temperature, blood circulation, symptom and sign, and function in the distal end (P<0.01). The curetive effects were more satisfactory in the group ( < 3 months) than the group ( > 3months) (P<0.01). The degree of improvement of the brachial artery was superior to that of the ulnar artery and to that of the radial artery. Conclusion The interval between arterial injuried and repaired had great influence on the recovery of the circulation, constraction and function in the distal end. Ole arterial injuries should be repaired as early and possible (the best within 3months). The repairment of brachial as ulner arterial injuries was more important.