【摘要】 目的回顾总结28例四肢假性动脉瘤的临床特点及随访疗效。方法应用显微外科技术治疗四肢假性动脉瘤28例,其中采用瘤体切除及动脉壁修补术4例、瘤体切除及动脉端端吻合术8例、瘤体切除及血管移植术16例(其中自体大隐静脉移植10例、头静脉移植4例、人造血管移植2例)。结果28例手术修复均获成功。3例伤口进行游离植皮的患者中2例一期愈合、1例部分植皮坏死、经换药2周后再次植皮成活。随访1~10年(平均5年零8个月),临床及超声波检查均显示修复动脉通畅且无假性动脉瘤复发。自体静脉移植的患者中有10例2年后超声波检查显示移植静脉轻度扩张,但无动脉瘤形成。有邻近神经发生受压症状的6例患者,在假性动脉瘤切除和动脉修复手术后6个月左右症状均消失,未造成患肢的功能障碍。结论外伤造成的动脉损伤是假性动脉瘤最常见的原因,医源性损伤所致有逐渐增多的趋势。对假性动脉瘤要尽早治疗,尽可能进行血管修复。彩色多普勒、超声波对假性动脉瘤的诊断帮助,MRI和血管造影可明确诊断。更多还原

【Abstract】 Objective To retrospectively summarize the clinical features and follow-up effects of 28 cases of pseudoaneurysms in limbs.Methods The microsurgical technique was used in the treatment of 28 patients with pseudoaneurysms in limbs.Among them,4 patients were treated with pseudoaneurysms resection and artery repair,8 patients with pseudoaneurysms resection and end to end artery anastomosis and 16 patients with pseudoaneurysms resection and autogenic vein transplantation,including 10 patients with autotransplantation of great saphenous vein,4patients with cephalie vein graft and 2 patients with artificial blood vessel transplantation.Results The operation was successfully performed on all 28 patients.The wound healing by first intention occurred in 2 of the 3 patients treated with free skin grafting.A patient with partial necrosis underwent skin grafting again and survived 2 weeks after the dressing.The mean follow-up period was 68 months(range;1-10 years).The clinical and ultrasound examinations showed the repaired artery was patent and no recurrence of pseudoaneurysms was found.Two years later,the ultrasound examination revealed mild venous dilatation in 10 of the patients with autogenic vein transplantation,but no aneurysms were noticed.At 6 months after the pseudoaneurysms resection and repair operation,the symptom disappeared in 6patients with adjacent nerve compression,and limb dysfunction did not occur.Conclusions Pseudoaneurysms are most commonly resulted from the artery injuries caused by trauma,but the iatrogenie false has gradually increased.The early treatment and vascular repair can ensure the satisfactory effects.The color Doppler ultrasound plays an important role in the diagnosis of pseudoaneurysms,and the Magnetic Resonance Imaging(MRI) and angiography help clarify the diagnosis.更多还原