CAJ | 학술논문

背景：国内外文献报道腰椎间盘手术并发腹部大血管损伤发生率较少，可一旦发生病情危急，抢救及处理不当可导致患者死亡或肢体功能障碍。 　　目的：探讨腰椎间盘髓核摘除致腹侧大血管损伤的发生原因、诊断及防治措施。 　　方法：复习1例腰椎间盘髓核摘除致髂总动脉损伤的诊断及防治措施。 　　结果与结论：患者L4/5椎间盘突出症行L4、L5右侧椎板减压髓核摘除导致髂总动脉损伤，通过及时诊断、采取外科干预及人工血管移植，抢救成功。大血管的损伤与手术操作、解剖、病理等因素有关，对于术中不能明确原因的椎间隙渗血伴有术中血压突然下降提示可能有大血管的损伤；准确诊断及迅速采取外科干预是抢救生命的关键。
배경：국내외문헌보도요추간반수술병발복부대혈관손상발생솔교소，가일단발생병정위급，창구급처리불당가도치환자사망혹지체공능장애。 　　목적：탐토요추간반수핵적제치복측대혈관손상적발생원인、진단급방치조시。 　　방법：복습1례요추간반수핵적제치가총동맥손상적진단급방치조시。 　　결과여결론：환자L4/5추간반돌출증행L4、L5우측추판감압수핵적제도치가총동맥손상，통과급시진단、채취외과간예급인공혈관이식，창구성공。대혈관적손상여수술조작、해부、병리등인소유관，대우술중불능명학원인적추간극삼혈반유술중혈압돌연하강제시가능유대혈관적손상；준학진단급신속채취외과간예시창구생명적관건。
BACKGROUND:Major abdominal vascular injury is a seldom serious complication during lumbar discectomy. Once occurring, it wil cause critical condition, and incorrect rescue and operation wil lead to patient’s death or functional disorder of the limbs. OBJECTIVE:To explore the cause, diagnosis, prevention and treatment action for major abdominal vascular injury caused by lumbar discectomy. METHODS:One case of common iliac artery injury caused by lumbar discectomy was reviewed in the aspects of diagnosis, prevention and treatment action. RESULTS AND CONCLUSION:The case suffered from common iliac artery injury caused by lumbar discectomy of right L 4-5 vertebrae, and achieved successful rescue by timely diagnosis, surgical intervention and artificial blood vessel transplantation. Injury of the vessels is relevant with many factors, including surgical operation, anatomy, pathology, etc. Unexplained intervertebral hemorrhage accompanied with sudden drop of blood pressure during surgery hints the possible occurrence of major vascular injury. Accurate diagnosis and instant surgical intervention is the key to rescue the patient’s life.