锁骨下血管损伤的救治

目的 探讨锁骨下血管损伤的有效治疗方法。方法 对15例锁骨下血管损伤的救治进行回顾性分析，本组6例行血管修补，3例行人造血管移植，2例行大隐静脉桥接，1例行直接端一端吻合。结果 手术修复成功12例，静脉修复后均无明显肢体肿胀，动脉修复术后1年随访，均可清晰地触及桡动脉搏动。其中2例并发臂丛神经损伤，术后1年随访未完全恢复。死亡3例。结论 对锁骨下血管损伤应做到诊断迅速，快速有效止血，及时补充血容量和纠正休克。手术修复应根据具体情况选择适当切口，严格遵循显微外科技术，针对不同的情况选择血管吻合、修补、自体静脉或人造血管移植。

Treatment of subclavian vascular injury

Objective To research the effective treatments of subclavian vascular injuries.?Methods The clinical data of 15 cases of subclavian vascular injury were analysed retrospectively.?There were 6 cases treated by direct suture,3 cases by artificial vascular prosthesis graft,2 cases by autogenous saphaneous vein graft and 1 case by end to end anastomosis.?Ther cause of injury,classifications and complications were analyzed.?Results Extremities survived and got good function in 12 cases.?Incomplete recovery of the brachial nerve was abserved in 2 cases.?After subclavian vessels reconstruction,clear pulses was observed in radial arteries.?There was no visible tumefaction of extrimities after repair of injured the veins when examined at the time of follow up.?Three cases died in this group.?Conclusion For subclavian vascular injuries,most important thing was correct diagnosis,quick hemostasis and proper treatment.?The management such as direct suture,artificial vascular prosthesis graft,autogenous saphaneous vein graft and end to end anastomosis should be selected according to the type of vascular injuries.?To improve the therapeutic effectiveness,we should select the proper exposure approach,conform to the microsurgical techniques strictly.