注射毒品致感染性假性股动脉瘤破裂19例外科治疗

目的 探讨注射毒品致感染性假性股动脉瘤破裂的外科治疗方法.方法 回顾分析19例注射毒品致感染性假性股动脉瘤破裂患者的临床资料,术前应用彩超或下肢血管造影诊断；8例采用人工血管行旁路髂外动脉和股浅动脉端端吻合术,11例行单纯瘤体两端股动脉结扎术.结果 全部病例手术成功,无继发肢体坏死；血管移植者术后复查彩色多普勒超声显示移植血管通畅.结论 瘤体切除+人工血管移植仍是治疗注射毒品所致假性股动脉瘤的理想方案；但在无条件行血管移植时,瘤体切除+股动脉结扎术是治疗的有效方法之一；不提倡行破裂瘤体修补术.

Surgical treatment of 19 cases of infected femoral pseudoaneurysms rupture caused by addicted drug injection

Objective To investigate the surgical treatment of infected femoral psudoaneurysm rupture caused by addicted drug injection. Methods The clinical data of 19 cases of ruptured infected femoral psudoaneurysm caused by drug injection were retrospectively analyzed. All the patients were diagnosed by Color Doppler Ultrasound or legs angiography. Eight patients received artificial vascular graft by externally vascular anastomosis between external iliac artery and superficial femoral artery, and the remaining 11 patients accepted proximal and distal ligation of the ruptured artery. Results All the patients were successfully operated, with no necrosis occurred in the affected limbs. Vessels functions were verified normal by Color Doppler Ultrasound after operation. Conclusion Excision of pseudoaneurysm plus the artificial vascular graft is the perfect surgical method for treating infected femoral psudoaneurysm rupture caused by addicted drug injection. Excision of pseudoaneurysm and ligation of the ruptured artery were also an effective procedure if there is no sufficient condition for artificial vascular graft. Repair of the rupture is not recommended.