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find Keyword "腘动脉损伤" 3 results
  • 腘动脉损伤的诊断与治疗

    目的 总结腘动脉损伤早期诊断、治疗与后期并发症处理的方法,最大限度恢复患肢功能。方法 1998年7月~2005年2月,收治39例国动脉损伤患者。男33例,女6例;年龄10~55岁,平均31.6岁。单纯腘动脉损伤6例,合并骨折33例。伤后1~6 d手术。伤后6 h以内入院及肢体缺血症状较轻者,骨折复位固定后恢复动脉通血;伤后超过6 h入院且肢体缺血症状较重者,恢复动脉通血后再处理骨折。后期皮缺损采用皮瓣移植修复,合并骨缺采用骨皮瓣移植。结果 35例成功保肢,其中10例伤口Ⅰ期愈合,25例Ⅱ期愈合;截肢4例。24例皮瓣完全成活,1例皮瓣部分坏死,经二期植皮后成活。患者均获随访6个月~4年,平均3.4年。骨折愈合时间10~34周。20例足部感觉于术后2 d~6个月恢复正常;2年后9例足底感觉恢复正常,6例足底及足背感觉均迟钝。根据杜天信等关于血管损伤的疗效评定标准:本组优10例,良24例,可1例,差4例,优良率87%。 结论腘动脉损伤的早期诊断、正确治疗,是减少截肢、提高肢体功能康复的关键。

    Release date:2016-09-01 09:22 Export PDF Favorites Scan
  • TREATMENT OF DELAYED POPLITEAL ARTERY TRAUMA OF KNEES

    Objective To summarize the experience in treatment and diagnosis of popliteal artery trauma and to determine the factors for amputation. Methods From February 1995 to January 2006, 28 patients with popliteal artery trauma were treated. The disease course was more than 8 hours. Of them, there were 25 males and 3 females, aging from 3 to 53 years. Trauma was caused by traffic accident in 12 cases, by falling from height in 3 cases, by firearm in 2 cases, by sharp instruments in 3 cases, by strangulation in 2 cases and by others in 6 cases. No arteriopalmus or weak arteriopalmus wereobserved in 18 cases and in 8 cases respectively. Popliteal artery exposure or active bleeding was seen in 2 cases; the popliteal arteries were examined by operation in 8 cases; color ultrasound Doppler flow imaging showed color flood flowsignals were through popliteal artery and its branches in 20 cases. Defect sizeof popliteal artery was less than 5 cm in 7 cases and more than 5 cm in 9 cases. End to end anastomosis reconstruction by saphenous vein graft and direct suture was performed in 16 cases and ampulation in 12 cases. The time of the revascularization of the leg was 8-150 hours (mean 31.8 hours). Results All patients were followed up 6 months to 11 years with an average of 4.2 years. In 16 cases given end to end anastomosis reconstruction, 15 cases achieved revascularization and limb survival; lower limb function restored to normal within 1 year in 12 cases; foot drop and ankle joint contracture occurred in 3 casesand the survival rate of limbs was 94%. Amputation was given in 12 of 28 casesbecause of severe trauma. The rate of amputation was 43% and the rate of disability was 54%. Conclusion Popliteal artery trauma should be treated as soon as the diagnosis is made. If the revascularization is more than 8 hours or circulatory compensation is not complete, it will affect the leg survival. Delayed diagnosis and severe traumas are the cause of high rate ofamputation in popliteal artery trauma.

    Release date:2016-09-01 09:23 Export PDF Favorites Scan
  • 膝关节多发韧带损伤脱位伴腘动脉损伤三例

    目的 总结3例膝关节多发韧带损伤脱位伴腘动脉损伤的诊疗经验。方法 2011年10月—2018年2月,收治3例膝关节多发韧带损伤脱位伴腘动脉损伤男性患者。患者年龄分别为27、70、31岁。损伤累及双侧1例、单侧2例。血管损伤时间10、4、3 h。采用一期修复血管、二期修复韧带治疗。结果患者住院时间分别为30、5、10 周,随访时间为9.5、3.5、3.0 年。 1例患者血管修复术后下肢皮肤、皮下组织部分坏死结痂,经再次植皮后愈合;其余患者切口均Ⅰ期愈合。所有肢体均成活,随访期间无感染、血管再损伤或新鲜血栓形成。末次随访时膝关节功能恢复良好,Tegner评分、Lysholm评分及美国特种外科医院(HSS)评分均较术前明显改善。1例合并双侧腘动脉损伤者并发双侧跟腱挛缩,1例术后膝关节不稳复发再次手术。结论膝关节多发韧带损伤脱位伴血管损伤临床较少见,多学科协作、及早发现和评估血管损伤、优先处理腘动脉损伤逆转肢体缺血及固定肢体是治疗此类损伤的有效方法,能够保存肢体并改善膝关节功能。

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