CAJ | 학술논문

目的探讨肢体大血管损伤救治的相关经验.方法对36例肢体大血管损伤患者实施积极救治,根据不同伤情行血管修补7例,直接端端吻合14例,自体静脉移植8例,游离皮瓣移植4例,分别处理合并伤.结果 36例中无死亡病例,截肢4例,肢体大血管修复33例,成功30例(90.9％)；肢体功能良好者27例(75.0％).结论对于肢体大血管损伤,院前与院内及时救治是挽救生命的前提；CT三维血管成像是明确诊断和指导手术探查的有效手段；血管修复不应严格限制缺血时长,尽早重建肢体循环仍是保存肢体、恢复功能的关键；妥善处理合并伤及并发症能提高临床疗效.
목적 탐토지체대혈관손상구치적상관경험.방법 대36례지체대혈관손상환자실시적겁구치,근거불동상정행혈관수보7례,직접단단문합14례,자체정맥이식8례,유리피판이식4례,분별처리합병상.결과 36례중무사망병례,절지4례,지체대혈관수복33례,성공30례(90.9％)；지체공능량호자27례(75.0％).결론 대우지체대혈관손상,원전여원내급시구치시만구생명적전제；CT삼유혈관성상시명학진단화지도수술탐사적유효수단；혈관수복불응엄격한제결혈시장,진조중건지체순배잉시보존지체、회복공능적관건；타선처리합병상급병발증능제고림상료효.
Objective To investigate the experience in the treatment of major vascular injury in limbs.Methods Took active treatment in the 36 cases of patients with vascular injury in limbs.Repaired of vascular injury with angioplasty in 7 cases,end-to-end anastomosis in 14 cases,autogenous vein graft in 8 cases,free flaps graft in 4 cases according to different conditions,and then handled the associated injuries respectively.Results There were no death of 36 cases,although 4 cases underwent amputation.The major blood vessels were repaired in 33 cases,30 cases of successful(90.9％).According to assessment,limb function was good in 27 cases(75.0％).Conclusions For major vascular injuries in limbs,pre-hospital and hospital timely treatment is the prime for life-saving; CT angiography is an effective measure of diagnosis and guiding surgical exploration ; vascular repair should not restrict the duration of ischemia strictly,and early reconstruction of limb cycle is the key to save the limb; properly handle the combined injuries and complications can improve the clinical efficacy.