吻合口假性动脉瘤的手术治疗

目的：探讨手术治疗吻合口假性动脉瘤（APA）的方法和效果。方法：11例APA患者均手术治疗。术前均用超声检查、动脉造影明确诊断。对于裂口较大者，采用吻合口假性动脉瘤切除（血肿清除）、人造血管或自体大隐静脉间置移植术（7例）；对于裂口较小者则采用人造血管或自体大隐静脉补片移植修复术（4例）。结果：1例失访，其余10例已分别随访5～38（平均19.6）个月。疗效良好者9例，均能恢复正常活动和工作；1例腘动脉吻合口假性动脉瘤压迫引起神经麻痹。所有患者均未见远端动脉供血不足现象，无复发。结论：APA均应手术治疗。术中有效的控制血流及彻底清除病灶（血肿）、术中及术后合理使用有效抗生素及抗凝剂是手术成功的保证。

Surgical treatment of anastomositic pseudoaneurysm: a report of 11 cases

ObjectiveTo study the operative procedure and effect of anastomostic pseudoaneurysm(APA). Methods Eleven patients with APA were treated surgically. The diagnosis of APA in all the patients was comfirmed by angiography and ultras onic examination. A small rupture leading to APA was repaired by lateral arteri orrhaphy using autologous vein patch in 4 cases; the APA caused by a big rupture of anastomosis,resection of the pseudoaneurysm and interposition o f a PTFE or antologous vein were used in 7 cases.Results10cas es were followed -up for 5-38 months (mean19.6 months),and 1case loss of follow-up.9 cases recovered to be normal in activities and works, only 1 ca se had nerve paralysis of the affect extremity caused by popliteal artery APA compression . All the cases have good blood perfusion of the extremities wit hout recurrence. Conclusions APA should be treated by surgery. During operation control blood vessels effectively and remove the pathological changetissues completely are important,and reasonable application of antibi otics and antithrombotic agents are the guarantee of getting successful results .