锁骨下血管神经损伤的处理

目的 探讨锁骨下动脉合并臂丛神经损伤的诊断和处理。方法 对5例锁骨下动脉损伤合并臂丛神经损伤患者，根据锁骨下动脉损伤性质，分别采用静脉移植、直接缝合、血管结扎处理；损伤臂丛神经采取直接缝合、神经松解。结果 3例开放性损伤早期手术修复动脉和神经，术后伤肢无疼痛，神经功能有不同程度恢复。2例闭合钝器伤晚期：1例行血管、神经松解术，仅疼痛减轻；1例血管臂丛神经广泛粘连，神经松解术后无任何恢复。结论 除原发性损伤外，进行性增大的血肿或假性动脉瘤压迫可加重臂丛神经损害，如能早期处理血肿或动脉瘤，解除压迫，可减轻神经损害，有利于臂丛神经功能恢复。

Treatment of Combined Subclavian Artery and Brachial Plexus Injury

Objective To investigate the treatment of combined subclavian artery and brachial plexus injury.Methods On five patients with combined subclavian artery and brachial plexus injury,vein graft(1 case),suture repair(1 cases),ligation(1 case) were performed respectively according to the site of subclavian injury,and neurolysis for 2 blunt injuries with mass organization of hematoma and tissue adhere. Results The 3 cases with open injury got recovery of nerve function to some extent due to the early surgical treatment of injured artery and nerve, wherease in the 2 blunt injury cases in late stage,I got pain relief but the other made no improvement because of vasculoreuroploxus adehesion. Conclusions Early treatment of hematoma and paseudoaneurysm compression on brachial plexus can reduce nerve damage and help recovery of brachial plexus function.