摘要:目的:探讨创伤性感染性假性股动脉瘤的诊断和外科治疗的临床经验。方法:回顾性分析２１例创伤性感染性假性股动脉瘤的临床资料,均行瘤体摘除及彻底的清创后,分别采用了血管结扎术和血管修复重建术两种不同的手术治疗方法。结果:血管修复重建术组中３例术后出现血管破裂大出血,要再次手术,１５例行股动脉结扎术,全部保肢成功。结论:瘤体切除加血管移植术是一种理想的方法,但在无条件行血管移植时,股动脉结扎术可做为一种有效的方案,对伴有皮肤缺损者行对侧胸脐皮瓣转移术。Abstract: Objective: 〖WT5”BZ〗To explore the traumatic infected femoral pseudoaneurysm diagnosis and surgical treatment of clinical experience. Methods: Retrospective analysis of 21 cases of traumatic infected femoral pseudoaneurysm of the clinical data were performed and the tumor removed after thorough debridement, respectively vascular ligation and blood vessel repair and reconstruction surgery of two different surgical treatment. Results: The blood vessel repair and reconstruction surgery group, three cases of postoperative bleeding blood vessel ruptures occurred, we must resurgery, 15 routine femoral artery ligation, all of the success of limb salvage. Conclusion: The tumor resection plus vascular graft is an ideal way, but in an unconditional line of vascular grafts, the femoral artery ligation can be used as an effective program for skin defects associated with the contralateral breast underwent umbilical flap transfer of patients.
Objective To evaluate repair and reconstructionof the femoral pseudoaneurysm caused by drug injection. Methods From May 2000 to May 2005, 15 cases of femoral pseudoaneurysm caused by drug injection underwent operation treatment. All patients were male, aging 20-36 years. The disease course was 18-52 days(mean 35 days) and the course of druginjection was 3-17 months. The locations were the left side in 5 cases and theright side in 10 cases. After having been bandaged with pressure and supportedwith nutrition, they had been all operated. One case received fistula repair, and 14 cases received vascular grafting with ePTFE man-made blood vessel. Results The wounds healed by the first intention in 14 cases. All limbs survived. The complexion, temperature and response of involved leg were in gear. The postoperative color ultrasound Doppler detection showed that all the vascular grafts were of patency. The function of the involved limbs restored to normal. Conclusion Complete debridement, vascular reconstruction and better microsurgery skill were the key factors of treating successfullythe femoral pseudoaneurysm caused by drug injection.
Objective To introduce the treatment and clinical result of reconstructing femoral artery with external jugular vein graft. Methods From June 2002 to April 2006, 22 cases of femoral artery defects caused by pseudoaneurysm resection, were reconstructed withexternal jugular vein graft by microsurgical technique. There were 20 males and2 females, aging 25-46 years (mean 31.2 years). The length of femoral artery defects was 5-9 cm, with an average of 6.8 cm. The location was left in 14 cases and right in 8 cases.Results Ten cases achieved healing by the first intention, and 4 cases by the second intention. The other 8 cases need the regional flap repair because the wound splited open and became ulcer. Femoral artery defects were reconstructed successfully and the pulse of dorsal arteries of foot could be felt except 1 case of bleeding of anastomotic rupture. Eighteen patients were followed up 1-30 months, and no pseudoaneurysm recurred. Color ultrasound Doppler detection showed that the external jugular veins took place of the femoral artery defects in 12 cases. Conclusion External jugular vein is stable at anatomy and easy-to-obtain. Its calibre is close to that of the femoral artery. It can be used for reconstructing femoral artery defects as the vein material. The operation is easy and the clinical result is sure.