CAJ | 학술논문

目的通过相关病例的分析,对四肢血管损伤修复手术中所应用的显微镜下缝线法和微血管吻合器两种不同血管吻合方式进行总结和评价. 方法回顾性分析2009年2月至2013年10月在我院行四肢血管显微外科吻合手术进行保肢治疗患者45例资料根据损伤血管直径以及血管口径的差别,术中采用了两种血管吻合方式:28例采用显微镜下缝线法吻合(显微镜组),17例采用微血管吻合器吻合(吻合器组).比较两组患者血管吻合时间、缺血再灌注时间以及手术后并发症率等. 结果显微镜组中总血管吻合时间以及缺血再灌注时间分别为(38.23±4.32) min和(87.33±4.16) min,明显高于吻合器组[分别为(13.38±2.81)min和(25.23±1.64) min],两组之间比较差异均有统计学意义(P＜0.05).显微镜组和吻合器组术后血管危象的发生率分别是30.1％和0. 结论应用微血管吻合器吻合血管,相比传统显微镜缝线法吻合可明显缩短血管吻合时间以及肢体缺血再灌注时间,有效降低血管吻合手术后并发症的发生率,提高手术质量和保肢成功率.
목적 통과상관병례적분석,대사지혈관손상수복수술중소응용적현미경하봉선법화미혈관문합기량충불동혈관문합방식진행총결화평개. 방법 회고성분석2009년2월지2013년10월재아원행사지혈관현미외과문합수술진행보지치료환자45례자료근거손상혈관직경이급혈관구경적차별,술중채용료량충혈관문합방식:28례채용현미경하봉선법문합(현미경조),17례채용미혈관문합기문합(문합기조).비교량조환자혈관문합시간、결혈재관주시간이급수술후병발증솔등. 결과 현미경조중총혈관문합시간이급결혈재관주시간분별위(38.23±4.32) min화(87.33±4.16) min,명현고우문합기조[분별위(13.38±2.81)min화(25.23±1.64) min],량조지간비교차이균유통계학의의(P＜0.05).현미경조화문합기조술후혈관위상적발생솔분별시30.1％화0. 결론 응용미혈관문합기문합혈관,상비전통현미경봉선법문합가명현축단혈관문합시간이급지체결혈재관주시간,유효강저혈관문합수술후병발증적발생솔,제고수술질량화보지성공솔.
Objective Based on the review of our experience in the clinical treatment effects of blood vessel damage in limbs to evaluate the values in the suture method under microscope and microvascular anastomotic device of microvascular anastomosis.Methods The subjects were 45 consecutive patients who had undergone the vascular injury treatments in limbs in our hospital between February 2009 to October 2013.During the operations,two methods of the anastomoses were applied:suture method under microscope for 28 patients;microvascular anastomotic device for 17 patients.The patients in the group were drawn out to compare among the 2 methods of the microvascular anastomoses as following:the microscopic group and the anastomotic device group.The comparison included the total anastomosing time,the ischemia time and the complication incidence within the two groups.Results In the anastomotic device group,anastomosing time and the ischemia time (38.23 ± 4.32 minutes and 87.33 ± 4.16 minutes,respectively)was obviously shorter than that in the microscopic group (13.38 ±2.81 minutes and 25.23 ± 1.64 minutes,respectively).There was significant statistical difference between the two groups (P ＜ 0.05).The blood supply associate complication incidences was 30.1％ in the microscopic group,0 in the anastomoses group.Conclusion The usage of microvascular anastomotic device can significant shorten the anastomoses time and the ischemia time of the vascular injury treatments,decreased the complication incidence.