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find Keyword "动脉损伤" 18 results
  • ANALYSIS OF THE MISTAKES IN THE MANAGEMENT OF INJURIES OF FEMORAL ARTERY

    The injuries of the femoral arteries were mistreated in 5 cases. The causes of the mistakes were resulted from: the initial cause of the injury was not carefully analyzed; the arterial injury was overlooked by the concomitant injuries, and the improper method of management was selected, as a result, 2 patients died from acute renal failure and the other 3 patients developed the complications of secondary thrombosis of the artery or rupture of the artery at the anastomotic site following repair. Of the 3 patients, 2 patients had recovered following reoperation and the other 1 patient had lost his limb from amputation. It should be emphasized that all of the following key points might avoid the mistakes occurred in the management of the injury of the femoral artery: (1) early diagnosis; (2) debredment of arteral end; (3) in infections wounds, insted of vein transplantation bypass technique should be done.

    Release date:2016-09-01 11:13 Export PDF Favorites Scan
  • LONGITUDINAL BIOMECHANICAL EFFECT ON REPAIR OPTIONS OF ARTERY INJURY

    OBJECTIVE: To investigate the relationship between the different defect length of vessels and the options of vascular repair, and to compare the different options of repair because of the longitudinal biomechanical effect. METHODS: A clinical analysis was undertaken to evaluate the major arterial and venous injuries in human extremities repaired by end-to-end anastomoses or venous autograft(177 cases, 185 vessels). Compared the defect length of the same kind of vessels repaired by different options (Student-t test). Evaluated the defect length to repair arterial injuries between by end-to-end anastomoses and by vein graft by means of 95% confidence interval. RESULTS: There was significant difference between the defect length of brachial artery repaired by end-to-end anastomosis and femoral artery and popliteal artery repaired by autogenous vein graft (P lt; 0.01). The upper limit of confidence interval in the defect length of brachial artery, femoral artery and popliteal artery was 3.17 cm, 2.81 cm and 2.44 cm respectively by end-to-end anastomosis by means of 95% confidence interval. The lower limit of confidence interval in the defect length of brachial artery, femoral artery and popliteal artery was 2.82 cm, 2.41 cm and 2.17 cm respectively by vein graft by means of 95% confidence interval. The defect length of brachial artery, femoral artery and popliteal artery repaired by vein graft was linear correlation with the length of graft. CONCLUSION: Because of the longitudinal biomechanical difference of arteries and veins in human extremities, different options of repair are necessary to different arterial injuries.

    Release date:2016-09-01 10:26 Export PDF Favorites Scan
  • Midterm follow-up results and postoperative aortic remodeling of blunt aortic injuries after endovascular treatment

    ObjectiveTo summarize the mid-term follow-up results and postoperative aortic remodeling of treating blunt aortic injuries (BAI) with thoracic endovascular aortic repair (TEVAR).MethodsA retrospective study was conducted on BAI patients treated with TEVAR, who were admitted into the Department of Vascular Surgery in Zhongshan Hospital, Affiliated to Fudan University between September 2003 and December 2015. There were 15 males and 9 females at an average age of 45.6±14.0 years. The mechanism of BAI was mainly auto car crash. Totally 25 entry tears were detected and most of them were located at the aortic isthmus.ResultsTwenty-four BAI patients survived and eventually went through TEVAR. One patient died of pulmonary embolism 1 week post-TEVAR. Rate of technical success, clinical success and perioperative mortality was 100.0%, 95.8%, and 4.2%, respectively. Nineteen patients were followed up with a mean time of 35.1(13-87) months. All of them survived this period. Based on the follow-up imaging of CTA, 18 of them revealed no endoleak or stent migration, and 1 patient of transection still had perfusion of distal false lumen at the abdominal aorta. None of the aortic segments measured in this study showed expansion of ≥5 mm during follow-up. The aorta remodeled well in 94.7% of them.ConclusionTEVAR for treating BAI appears feasible with high rates of technical and clinical success rates. The mid-term follow-up results seems satisfying, but the long-term results are yet to be assessed with further follow-up.

    Release date:2018-03-28 03:22 Export PDF Favorites Scan
  • 直视双极射频消融损伤右冠状动脉主干合并左心室后壁破裂一例

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  • 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
  • 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。

    Release date:2022-01-27 11:02 Export PDF Favorites Scan
  • INTERVENTION ASSISTANT OPERATION IN TREATMENT OF PHALANX CLOSED FRACTURE COMBINED WITH ARTERY CRISIS

    To explore the effectiveness and methods of intervention assistant operation in the treatment of phalanx closed fracture combined with artery crisis. Methods Between August 2002 and December 2008, 24 cases (31 toes) of phalanx closed fracture combined with artery crisis were treated. There were 17 males (22 toes) and 7 females (9 toes), aged from 16 to 62 years (mean, 38 years). The causes of injury included crush and bruise (20 cases), traffic accident (3 cases),and machine twist (1 case). The locations were the first toe (19 toes), the second toe (10 toes), and the third toe (2 toes). The period between injury and hospital ization was 1-10 hours (mean, 6.8 hours). Phalanx angiography was performed by using venous indwell ing needle for dorsal is pedis artery and posterior tibial artery puncture; according to angiography results, proper treatment could be done, then the constrast medium was injected to the artery to observe the blood supply. According to different types and locations of fracture, Kirschner wire and plate were choosen to fix fracture after the blood supply were recovered. Results Two cases (2 toes) received amputation due to necrosis at 4 days and 6 days after interventional therapy, respectively. Twenty-two cases (29 toes) survived. Incision healed primarily in 21 cases. Exudation occurred at wound of 1 case and was cured at 3 weeks after dressing change. Twenty-two cases (29 toes) were followed up 1-6 years (mean, 3.5 years) postoperatively. Two cases (3 toes) felt cool or anaesthesia and could not tolerate even in cold environment. The other toes had no senses of cold pain and paresthesia. Two cases (2 toes) had nonunion and achieved fracture heal ing after grafting bone. The mean union time was 4.5 months (range, 3-6 months) in other cases. Conclusion Intervention assistant operation is an effective measure in the treatment of phalanx closed fracture combined with artery crisis.

    Release date:2016-08-31 05:48 Export PDF Favorites Scan
  • 四肢主干动脉损伤早期诊断与修复

    目的 总结四肢主干动脉损伤应用显微外科技术修复的经验。方法 1997年8月~2006年8月,对200例(316条)四肢主干动脉损伤患者,采用显微镜下血管吻合、修补、自体静脉移植或人工血管移植,并同时对缺损皮肤和肌腱进行一期修复或二期功能重建。血管损伤类型:开放性损伤161例,闭合性损伤39例。完全断裂189条,不完全断裂127条。血管缺损2~8 cm。结果 术中输血量800~4 000ml。手术成功(一次修复)169例,血栓形成二次修复19例,术后死亡3例,截肢9例。126例获随访3个月~4年,120例肢体血液循环恢复正常,6例肢体存在不同程度功能障碍,可能与合并神经损伤有关。结论 对于四肢主干动脉损伤,采用显微外科技术修复,能获得良好效果,明显提高患肢存活率。

    Release date:2016-09-01 09:23 Export PDF Favorites Scan
  • INJURY OF FEMORAL ARTERY COMPLICATED WITH INFECTION FROM INJECTION OF HEROINE

    Drug addiction has been one of the serious social problems. The peripheral phlebitis caused by drug injection is common, but the occurrence of pseudoaneurysm with infection of femoral artery from injection injury was rarely reported in China. From January 1995 to March 1996, six cases of injury of femoral artery with infection from heroine injection were admitted. The characteristics of the injury were described. The therapeutic measures and details of attention to be needed were discussed. It was concluded that this type of injury was different from the injury caused in agricultural, industrial or traffic accidents. The treatment of choice depended upon the type of injury.

    Release date:2016-09-01 11:07 Export PDF Favorites Scan
  • ISCHEMIC CONTRACTURE FOLLOWING ARTERIAL INJURIES IN LIMBS

    Abstract During 1960 to 1995, 19 of the 269 casesof arterial injuries in limbs treated developed ischemic contracture (7.06%), in which 14 in the lower limbs and 5 in the upper limbs. In the 19 cases, 3 injured arteries were not treated; 1 had his injured arteries repaired infailure; 5 cases had the concomitant veins injured, and 3 of them had their injured veins ligated in the primary treatment. Only 1 case received fasciotomy in his former treatment in other hospital. Four cases were admitted in our Institute in 14 hours, 8 cases were 34 to 57 hours and 7 were 19 days to 19 months after injury. Seventeen out of the 19 injured ateries and 5 out of the 8 injured vein were repaired. Eight cases received fasciotomy. The follow up ranged from 3months to 28 years (averaged 5 years). Sixteen out of the 17 injured arteries remained patent after repair, and the patency were proved by Bultrasound. The causes of ischemic contracture in these cases were analyzed. It was concluded that in order to prevent the limb from ischemic contracture, it should be emphasized that the accurate diagnosis of the injury of the artery and its concomitant ein be made early, the proper treatment be given to the injured artery and vein,and fasciotomy be done immediately as indicated.

    Release date:2016-09-01 11:11 Export PDF Favorites Scan
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