中华普通外科杂志
中華普通外科雜誌
중화보통외과잡지
CHINESE JOURNAL OF GENERAL SURGERY
2012年
5期
388-391
,共4页
杨牟%张居文%车海杰%勇俊%李鲁滨%陈萍%孙林%宋富波%郑磊
楊牟%張居文%車海傑%勇俊%李魯濱%陳萍%孫林%宋富波%鄭磊
양모%장거문%차해걸%용준%리로빈%진평%손림%송부파%정뢰
创伤和损伤%支架%四肢%血管腔内治疗
創傷和損傷%支架%四肢%血管腔內治療
창상화손상%지가%사지%혈관강내치료
Wounds and injuries%Stents%Extremities%Endovascular treatment
目的 探讨腔内治疗闭合性肢体动脉外伤的手术方式及有效性.方法 回顾性分析2006年3月至2010年12月治疗的12例腔内治疗闭合性肢体动脉外伤患者的临床资料.对12例患者均顺行或逆行穿刺置入导管鞘,在导丝配合下将导管送至病变近心端,通过术中造影确定动脉病变的具体位置,并精确测量动脉的直径及受累动脉段的长度.导管配合下将导丝通过病变部位建立治疗“通路”,在病变部位释放相应类型的支架修复动脉损伤.结果 12例患者均成功完成手术,手术成功率100％,无死亡病例,2例患者术后出现急性肾功能衰竭,给予连续性静脉-静脉血液滤过治疗后治愈,3例患者因肢体骨筋膜室综合征于术中或术后行骨筋膜切开减压术,其中1例因肌肉组织坏死严重、肢体功能丧失最终截肢.11例患者完成1年随访,随访率92％,损伤动脉均通畅,未发现支架断裂、移位或狭窄.结论 腔内技术治疗闭合性肢体动脉外伤创伤小、安全有效.
目的 探討腔內治療閉閤性肢體動脈外傷的手術方式及有效性.方法 迴顧性分析2006年3月至2010年12月治療的12例腔內治療閉閤性肢體動脈外傷患者的臨床資料.對12例患者均順行或逆行穿刺置入導管鞘,在導絲配閤下將導管送至病變近心耑,通過術中造影確定動脈病變的具體位置,併精確測量動脈的直徑及受纍動脈段的長度.導管配閤下將導絲通過病變部位建立治療“通路”,在病變部位釋放相應類型的支架脩複動脈損傷.結果 12例患者均成功完成手術,手術成功率100％,無死亡病例,2例患者術後齣現急性腎功能衰竭,給予連續性靜脈-靜脈血液濾過治療後治愈,3例患者因肢體骨觔膜室綜閤徵于術中或術後行骨觔膜切開減壓術,其中1例因肌肉組織壞死嚴重、肢體功能喪失最終截肢.11例患者完成1年隨訪,隨訪率92％,損傷動脈均通暢,未髮現支架斷裂、移位或狹窄.結論 腔內技術治療閉閤性肢體動脈外傷創傷小、安全有效.
목적 탐토강내치료폐합성지체동맥외상적수술방식급유효성.방법 회고성분석2006년3월지2010년12월치료적12례강내치료폐합성지체동맥외상환자적림상자료.대12례환자균순행혹역행천자치입도관초,재도사배합하장도관송지병변근심단,통과술중조영학정동맥병변적구체위치,병정학측량동맥적직경급수루동맥단적장도.도관배합하장도사통과병변부위건립치료“통로”,재병변부위석방상응류형적지가수복동맥손상.결과 12례환자균성공완성수술,수술성공솔100％,무사망병례,2례환자술후출현급성신공능쇠갈,급여련속성정맥-정맥혈액려과치료후치유,3례환자인지체골근막실종합정우술중혹술후행골근막절개감압술,기중1례인기육조직배사엄중、지체공능상실최종절지.11례환자완성1년수방,수방솔92％,손상동맥균통창,미발현지가단렬、이위혹협착.결론 강내기술치료폐합성지체동맥외상창상소、안전유효.
Objective To explore the effect of endovascular treatment for closed limb artery trauma. Methods From March 2006 to December 2011,the clinical data of 12 cases treated for closed limb artery trauma were analyzed retrospectively.Catheters sheath were placed by antegrade or retrograde puncture.Catheters was send to the proximal end of the lesion.Intraoperatively through angiography the location and extent of arterial lesions were determined.Catheter with the help of guidewire were sent through the lesion to establish treatment “ pathway",at the lesion site suitable stents were placed to repair damaged arteries. Results The procedure was all successful in 12 patients,there was no mortality nor sever compalications.Postoperatively 2 cases suffered from acute renal failure,and were managed and cured by continuous veno-venous hemofiltration (CWH).Osteofascial compartment incision decompression was carried out in 3 cases due to osteofascial compartment syndrome.One case of them suffered from amputation due to sever muscle necrosis and lost of limb function.Eleven patients were followed-up for 1year.All the arteries were patent.There were no stent break,deformation or stenosis. Conclusions Endovascular techniques for the treatment of closed limb arterial trauma is safe and effective.
