摘要
背景:四肢血管损伤常伴血管缺损,常用血管移植进行修复,但存在移植后感染及血管闭塞等缺点。目的:分析44例四肢血管损伤患者应用血管移植后的血管重建效果。设计:回顾性病例分析。单位:金华职业技术学院附属医院血管外科、骨科。对象:选择1994-04/2003-10在金华职业技术学院附属医院血管外科、骨科行自体和人造血管移植的四肢血管损伤患者44例,损伤类型为开放性损伤29例,闭合性损伤15例。方法:44例患者共移植血管52条,其中采用自体静脉移植42条,包括大隐静脉移植端端吻合术35条,小隐静脉移植端端吻合5条,股浅-腘静脉段2条;人造血管与修整后的血管行端端间断吻合移植10条。主要观察指标:自体和人造血管移植效果。结果:44例患者中截肢3例;肢体缺血性肌挛缩6例;神经功能恢复不完全7例;2例人工血管移植物感染行股浅-腘静脉股原位置换。其余移植血管均通畅,远端肢体血循环良好。结论:血管移植治疗血管损伤应尽量采用自体静脉移植,必要时可使用人造血管;移植后需积极防治血管感染等并发症的发生。
BACKGROUND： Vascular injuries to the extremities are frequently concomitant with vascular defects. Vascular transplantation repair can induce infection and vascular occlusion, etc.
OBJECTIVE： To analyze the outcome of vascular reconstitution in 44 patients with vascular injuries of the extremities undergoing vascular transplantation.
DESIGN： A retrospective case analysis.
SETTING： Department of Vascular Surgery and Department of Orthopaedics of Hospital Affiliated to Jinhua College of Profession and Technology.
PARTICIPANTS： Forty-four patients with vascular injuries to the extremities undergoing autologous and artificial vascular transplantation were selected at the Department of Vascular Surgery and Department of Orthopaedics of Hospital Affiliated to Jinhua College of Profession and Technology from April 1994 to October 2003. There were 29 patients with open injury and 15 patients with closed injury.
METHODS： A total of 52 blood vessels were transplanted into 44 patients, including 42 blood vessels in autologous vein transplantation （35 blood vessels in great saphenous vein transplantation by end-to-end anastomosis, 5 blood vessels in small saphenous vein transplantation by end-to-end anastomosis and 2 blood vessels in superficial femoral vein and popliteal vein transplantation） and 10 blood vessels in artificial and trimming vascular transplantation by interrupted suture technique in end-to-end anastomosis.
MAIN OUTCOME MEASURES： Outcomes of autologous and artificial vascular transplantation.
RESULTS： Three patients received amputated extremity. Six patients developed ischemic contracture. Seven patients developed imperfect recovery of nerve function. In other patients, blood flow in the graft was satisfactory, and there was good condition of blood circulation at the distal extremities.
CONCLUSION： Autologous vein is the first choice in vascular transplantation, and prosthetic material is another choice when necessary. It is important to prevent the occurrence of complication after transplantation such as vascular infection.
出处
《中国组织工程研究与临床康复》
CAS
CSCD
北大核心
2008年第31期6177-6180,共4页
Journal of Clinical Rehabilitative Tissue Engineering Research
