摘要
目的评估超声引导下局部压迫和手术治疗医源性股动脉假性动脉瘤的疗效并介绍治疗经验。方法1995年4月至2008年4月对197例医源性股动脉假性动脉瘤病人进行治疗，其中171例首选超声引导下局部压迫治疗（假性动脉瘤稳定者），26例（假性动脉瘤破裂或瘤腔直径≥40mm者）直接手术治疗。结果压迫治疗的171例中137例压迫成功，有效率80％，34例失败者改行手术治疗。直接手术治疗的26例及上述改行手术的34例中，47例行股动脉假性动脉瘤切除、动脉壁破口修补术，6例行自体大隐静脉补片成形术，7例行人工血管转流术。围手术期所有手术病例无出血、神经痛、淋巴瘘、动静脉瘘等严重并发症和死亡。随访1个月至5年，均未见假性动脉瘤复发或肢体缺血症状。随访期间无死亡。结论局部压迫疗法治疗医源性股动脉假性动脉瘤安全、有效、经济，可作为大部分稳定病人的首选治疗方法。不适合压迫治疗者及压迫治疗失败的病人可手术治疗，疗效确切。
Objective To evaluate the effect on ultrasound-guided local compression and surgical repair to treat iatrogenic femoral artery pseudoaneurysms. Methods 197 patients were diagnosed as iatrogenic femoral artery pseudoaneurysms from April 1995 to April 2008 .There were 122 male and 75 female, aged 59.7 years （ranged 40 - 81 years）. One hundred and seventy-one stable cases were managed by ultrasound-guided local compression initially and 26 patients were directly treated with surgical repair because of the rupture of femoral artery pseudoaneurysms or the pseudoaneurysms ≥40 mm in diameter. Results 171 patients rece.ived local compression therapy, 137 cases were cured directly （the effective rate was 80% ）, but the last failed 34 cases were required conversion to surgical repair. The number of the surgical repaired patients was 60 （ including 26 cases with direct operation and 34 cases with required conversion to surgical repair）. Forty-seven patients received direct excision of femoral artery pseudoaneurysm, six patients underwent angioplasty with autagenonsly saphenous vein patch, and seven patients got bypass operation with artificial vascular graft. During the perioperative period, no serious complications including bleeding, neuralgia, and lymphatic fistula even arterio venous fistula and so on, no death occurred. All patients were followed up for 1 month to 5 years after the procedures, no local FAP recurred, no limb ischemia developed and no deaths occurred. Conclusion Ultrasound-guided compression, sttrgical repair, and ultrasound- guided percutaneous thrombin injection are the three main modalities of treating iatrogenic FAP, while ultrasound-guided compression and surgical therapy get popularized domestically. Ultrasound-guided compression seems a safe, inexpensive, and effective method for the management of iatrogenic femoral artery pseudoaneurysms. It may be used as a first-line therapeutic medality for most of the uncomplicated patients. However, surgical repair can be reserved for those who failed compression therapy or unsuitable as mentioned above.
出处
《中华胸心血管外科杂志》
CSCD
北大核心
2009年第3期151-153,共3页
Chinese Journal of Thoracic and Cardiovascular Surgery
关键词
动脉瘤
假性
股动脉
医原性疾病
血管外科手术
Aneurysm, false Femoral artery Iatrogenic disease Vascular surgical procedures
