摘要
目的 对 1989～ 2 0 0 1年救治的 6 9例四肢骨折、脱位伴主要血管损伤进行回顾分析。方法 6 9例中 ,男 5 7例 ,女 12例 ;年龄 13～ 6 2岁 ,平均 31.6岁。确诊和手术探查后 ,先分别用带锁髓内针、钢板螺钉和外固定支架固定骨折和脱位 ,再针对不同的情况选择血管直接修补术、血管端端吻合术和血管移植术等。 结果 本组无死亡 ,肾功能衰竭 2例 ,截肢 7例 ;手术成功修复 6 2例 ;43例获得平均 3 .1年的随访 ,4例骨不连。 结论 四肢骨折、脱位伴主要血管损伤较单纯血管损伤并发休克率高 ,漏诊率高 ;救治原则是生命第一、肢体第二 ;既要有稳固的骨支架 ,又要修复好血管 ,这样才能获得良好的结果。
Objective To retrospectively study 69 cases of fractures and/or dislocations complicated by major vascular injuries in extremities from 1989 to 2001 treated in our department. Methods There were 57 males and 12 females with a mean age of 31.6 years (13-62 years). After diagnosis and operative exploration, the fixation of fractures and/or dislication was done first followed by repair of vascular injuries based on the condition of the fractures. Results There was no death. However, there were 2 cases with kidney function failure and 7 with amputation. Successful reconstruction was carried out in 62 cases. Of 43 cases followed up for mean 3.1 years, 4 cases were found with bone nonunion. Conclusions There is a higher rate of misdiagnosis and shock complication in those with fractures and/or dislocations complicated by major vascular injuries in extremities than those with single fractures. The principle of the management is life prior to extremities. The rigid fixation of fractures and/or dislocation and the repair of the vascular injuries should be used together so as to attain a satisfactory outcome.
出处
《中华创伤杂志》
CAS
CSCD
北大核心
2003年第1期40-41,共2页
Chinese Journal of Trauma
关键词
四肢骨折
创伤
损伤
血管
血管外科手术
Fractures, extremities
Wounds and injuries
Blood vessel
Vascular surgical procedures
