CAJ | 학술논문

目的探讨DSA在评价断指再植血管及血流状况中的价值.方法 12例断指再植患者术后2～4 d行再植指体DSA检查,观察再植指体血管轮廓、吻合口形态、血液动力学改变、有无血管痉挛或血栓及侧支循环建立情况,根据造影结果确定进一步的处理方案.结果共27条吻合血管中,DSA全部显示清晰,其中9例23条吻合血管血流通畅,均存活,断指再植指体早期存活诊断符合率为100%(23/23).2例(右手中指和无名指各1例)吻合血管中断,考虑重度血管危象,即行手术探查发现血栓;1例(左手无名指和小指)吻合动脉痉挛变细,提示轻度血管危象,经保守治疗最终存活.DSA对4条吻合血管病变均检出.结论 DSA能够对再植指体血供重建和血液循环情况作出客观、准确的评价,在指导临床对再植指体的进一步处理及预测再植指体早期存活方面具有重要意义.
목적 탐토DSA재평개단지재식혈관급혈류상황중적개치.방법 12례단지재식환자술후2～4 d행재식지체DSA검사,관찰재식지체혈관륜곽、문합구형태、혈액동역학개변、유무혈관경련혹혈전급측지순배건립정황,근거조영결과 학정진일보적처리방안.결과 공27조문합혈관중,DSA전부현시청석,기중9례23조문합혈관혈류통창,균존활,단지재식지체조기존활진단부합솔위100%(23/23).2례(우수중지화무명지각1례)문합혈관중단,고필중도혈관위상,즉행수술탐사발현혈전;1례(좌수무명지화소지)문합동맥경련변세,제시경도혈관위상,경보수치료최종존활.DSA대4조문합혈관병변균검출.결론 DSA능구대재식지체혈공중건화혈액순배정황작출객관、준학적평개,재지도림상대재식지체적진일보처리급예측재식지체조기존활방면구유중요의의.
Objective To assess revascularization and vessel anastomosis in digital replantations with DSA.Methods Twelve cases of digital replantations underwent digital subtract angiography during 2 to 4 days after fingers reattachment. The vessel anastomosis,hemodynamics,stenosis and discontinuation were investigated.The unobstructed and smooth anastomosis was suggested as early stage survival of the reattached fingers,the spasm and stenosis of the reattached vessels were considered as mild vascular crisis,and the discontinuation of hemodynamics were indicated as severe vascular crisis.Results The total 27 vessels were clearly displayed on DSA.Of these vessels,23 vessels were unobstructed and smooth,all digits were survived.Diagnosis coincidence of early stage survival was 100%(23/23). Two vessels were obstructed,which were testified having thrombus by operation research.The other 2 vessels were spasm,the digits were also survived ultimately by expectant treatment.All 4 abnormal vessel anatomosis were found by DSA.Conclusion DSA is important modality in assessing revascularization and blood circulation for digital replantations,guiding in dealing with the vascular crisis,and in predicting early stage survival of the reattached digits.