| 四肢主干动脉外伤缺损长度的判断与修复重建 |
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Received:June 20, 2013
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| 期刊信息：《中国骨伤》2014年27卷，第3期，第199-202页 |
| DOI：10.3969/j.issn.1003-0034.2014.03.007 |
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目的：研究四肢主干动脉损伤实际缺损长度、缺损裂隙宽度对修复重建选择的影响。
方法：回顾性研究1996年至2009年治疗的32例四肢主干动脉损伤患者，其中男30例，女2例；成人30例，年龄18～51岁，平均36岁，儿童2例，年龄分别为4岁和5岁。受伤部位：腋动脉4例、肱动脉7例、桡动脉2例、股动脉4例、腘动脉13例和胫后动脉2例。观察分析动脉损伤后缺损裂隙的宽度以及形成原因，对所有病例采取了血管拉伸后端端吻合的方法进行修复。
结果：动脉缺损裂隙宽度3～7 cm，平均（4.375±1.200） cm，上肢肱动脉和腋动脉11例（5.73±0.63） cm，下肢股动脉和腘动脉17例（3.80±0.73） cm，胫后动脉2例（3.25±0.35） cm，桡动脉2例（3.00±0.00） cm.上肢肱动脉和腋动脉缺损间隙宽度大于其他3个部位（P<0.01）.所有患者血管端端吻合成功，血运恢复良好。因肢体感染后期截肢2例。所有患者得到随访，不伴骨折患者随访至术后2周，伴骨折患者至少随访1年，所有患者肢体血运良好。
结论：血管缺损裂隙宽度不同于实际血管缺损，而是大于实际血管缺损，对血管缺损长度的错误判断将导致更多的血管移植。绝大多数的血管外伤缺损可以通过血管游离，拉伸延长后直接修复。 |
| [关键词]:四肢 动脉 创伤和损伤 修复外科手术 |
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| Judgment of defect length of extremities artery trauma and reconstruction |
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Abstract:
Objective: To study the influence of actual defect length and gap width of the limbs main artery on the method selection of repairing and reconstruction.
Methods: Retrospective study was carried out for 32 patients with extremity main artery injury from 1996 to 2009,including 30 males and 2 females; 30 adults with an average age of 36 years old ranging from 18 to 51 years,2 children of 4 and 5 years old respectively. Injured body parts involved axillary artery in 4 cases,brachial artery in 7 cases,radial artery in 2 cases,femoral artery in 4 cases,popliteal artery in 13 cases,posterior tibial artery in 2 cases. Main arterial injury defect gap width of all cases were observed and the reasons were analyzed. All cases were repaired by the method of end to end anastomosis after vessels stretch.
Results: The artery defect width was 3 cm to 7 cm with an average of(4.375±1.200) cm. Defect width of the upper extremity brachial artery and axillary artery group was(5.73±0.63) cm,the lower extremity femoral and popliteal artery group(3.80±0.73) cm,the posterior tibial artery group(3.25 ± 0.35) cm,the radial artery group(3.00±0.00) cm. Defect width of upper extremity brachial artery and axillary artery group was larger than that of the other three groups(P<0.01). End to end anastomosis was performed successfully in all cases. Blood supply recovered well. Because of the severe limb infection 2 patients had amputation in the late. All patients received follow-up. The patients without fracture were followed up to 2 weeks postoperatively,all patients with fractures were followed up to 1 year at least. Limb blood supply was good in all patients during the follow-up.
Conclusion: Blood vessel defect gap width is different from the actual vessel defect,but is larger than the actual vessel defect. Misjudgment of the vascular defect length will lead to more vascular transplantation. The vast majority of vascular defect can be directly repaired by the method of end to end anastomosis after the vessel free and stretch. |
| KEYWORDS:Extremities Arteries Wounds and injuries Reconstructive surgical procedures |
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| 引用本文，请按以下格式著录参考文献： |
| 中文格式: | 祁峰,李杰,祁晓,肖鲁伟.四肢主干动脉外伤缺损长度的判断与修复重建[J].中国骨伤,2014,27(3):199~202 |
| 英文格式: | QI Feng,LI Jie,QI Xiao,XIAO Lu-wei.Judgment of defect length of extremities artery trauma and reconstruction[J].zhongguo gu shang / China J Orthop Trauma ,2014,27(3):199~202 |
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