四肢主干动脉损伤84例救治分析

目的探讨四肢主干动脉损伤后的诊治方法及效果。方法 84例四肢主干血管损伤患者应用显微外科技术,端-端吻合59条,大隐静脉移植修复26条,血管修复缝合11条。结果治愈82例,截肢2例,并发急性肾功能衰竭2例,血管破裂二次探查修复1例。结论四肢主干血管的损伤修复越早越好。缺损超过2 cm应取大隐静脉桥接,缺血超过6 h应采用血管取栓器取栓,常规行远端肢体切开减压,预防筋膜间室综合征。提高治愈率,降低后遗症和截肢率。

Treatment analysis of main artery injured limbs in 84 cases

Objective To study the diagnosis,treatment measures and effect of main artery injured limbs.Methods 84 cases of main vascular injured limbs were treated by microsurgical technique,end-end anastomosis were performed in 59 blood vessels,great saphenous vein graft in 26,and blood vessels repair in 11.Results There were 82 cured cases,amputation in 2 cases,2 cases of concurrent acute renal failure,and reoperation in 1 case cause of vascular rupture.Conclusion The limbs with main artery injured operation the sooner the better.Great saphenous vein bridging should be taken if there is a vessel defect more than 2cm,thrombus removal should be adopted after ischemia more than 6h.Routine distal limb decompression could prevent compartment syndrome,improve the curative effect,and reduce sequelae and amputation rate.