创伤性感染性假性动脉瘤的外科治疗

Surgical management of infective posttraumatic pseudoaneurysms in 12 cases

  • 摘要: 目的:总结创伤性感染性假性动脉瘤的外科治疗及疗效。方法:创伤性感染性假性动脉瘤12例,年龄15~65岁,平均32岁。伤后3d~14d,平均6d,患者均经手术治疗,根据动脉损伤情况采用不同的血管修复方法。手术行单纯动脉结扎3例,经动脉瘤腔破口修补3例,解剖外旁路血管移植6例。结果:无围手术期死亡,7例切口Ⅰ期愈合,5例切口Ⅱ期愈合。随访3月~1年,动脉自体静脉移植术后3月移植血管闭塞,2例人造血管分别在术后6月、1年,移植血管吻合口狭窄。下肢软瘫患者1年后肢体功能部分恢复,其余患者恢复良好。结论:假性动脉瘤合并感染时的早期手术治疗,处理得当是安全的,彻底清创和血管重建是治疗创伤性感染性假性动脉瘤的有效方法。

     

    Abstract: Objective:To investigate the effect of surgical therapy for the infective post-traumatic pseudoaneurysms.Methods:Ages of the patients were 15~65 years,the averge ages 32 years,hospitalization to operation were two days~five days.The methods of different operation were selected according to the type of vascular injuries.Simple ligation was performed on 3 cases,transaneurysm artery defect suture on 3 cases,auto-vein or artificial blood vessel extra-anatomic bypass on 6 cases.Results:Perioperalive period no died.All patients were followed-up survey 3 months to 1year,Wound healing was Ⅰ intention on 5 cases,Ⅱ intention on 5 cases.After three months,auto-vein graft had obliterated.Artificial blood vessel graft had anastomotic stoma stricture on 2 cases,post-operative six months 、one year,respectively. Conclusions:Surgical therapy was safeness for the infective aneurysm at early stage.Clearing necrosis tissue completely and reconstruction of artery is an effective means that treat infective post-traumatic pseudoaneurysms.

     

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