發(fā)布時間：2018-02-26 04:36

  本文關(guān)鍵詞： 數(shù)字減影血管造影 Fogarty導(dǎo)管 離斷肢體 再植術(shù) 動脈危象　出處：《廣東醫(yī)學(xué)》2017年20期 　論文類型：期刊論文

【摘要】：目的觀察DSA聯(lián)合雙腔Fogarty導(dǎo)管在斷肢再植術(shù)后動脈危象中應(yīng)用的臨床療效。方法 DSA聯(lián)合雙腔Fogarty導(dǎo)管用于斷肢再植術(shù)后動脈危象的患者19例,術(shù)后17例順利成活,切口均Ⅰ期愈合,其中1例出現(xiàn)急性肝功能損害,予以內(nèi)科綜合治療,急性肝功能損害糾正,1例出現(xiàn)骨筋膜室綜合征,行手術(shù)切開治療,恢復(fù)良好。術(shù)后2例再次出現(xiàn)動脈危象,行切開探查術(shù),1例治療成功,1例動脈閉塞,肢體部分壞死,行截肢術(shù)。結(jié)果所有病例未發(fā)生血管穿孔、傷口感染等并發(fā)癥。血栓存在于動脈內(nèi),長度為0.8~4.5 cm。排除切開探查術(shù)的2例患者,采用Fogarty導(dǎo)管處理的17例患者,平均隨訪13個月(9~36個月),肢體血運良好,皮溫正常,感覺改善,活動度改善。參照中華醫(yī)學(xué)會手外科學(xué)分會斷肢再植功能評定試用標(biāo)準(zhǔn)評價療效,本組優(yōu)10例、良4例、差3例,優(yōu)良率82.3%。結(jié)論應(yīng)用DSA聯(lián)合雙腔Fogarty球囊導(dǎo)管處理斷肢再植術(shù)后動脈危象,可避免斷端修復(fù)區(qū)域二次損傷,臨床效果滿意。
[Abstract]:Objective to observe the clinical effect of DSA combined with double-lumen Fogarty catheter in the treatment of arterial crisis after replantation of severed limbs. Methods DSA combined with double-lumen Fogarty catheter was used in 19 patients with arterial crisis after replantation of severed limbs. All the incisions were healed in the first stage. One case with acute liver function damage was treated with comprehensive medical treatment, and one case with osteofascial compartment syndrome was corrected for acute liver function damage, which was treated by surgical incision. The recovery was good. After operation, 2 cases appeared artery crisis again, 1 case was successfully treated with open exploration, 1 case had artery occlusion, partial limb necrosis, and amputation. Results no perforation of blood vessel occurred in all cases. Complications such as wound infection. Thrombosis was found in the artery with a length of 0.8 ~ 4.5 cm. 17 patients treated with Fogarty catheter were followed up for an average of 13 months, with good blood flow, normal skin temperature and improved sensation. According to the evaluation criteria of replantation function in the Chinese Medical Association, 10 cases were excellent, 4 cases were good, 3 cases were poor. Conclusion the treatment of arterial crisis after severed limb replantation with DSA combined with double-lumen Fogarty balloon catheter can avoid secondary injury in the repaired region of the severed limb, and the clinical effect is satisfactory.
【作者單位】： 承德醫(yī)學(xué)院附屬醫(yī)院手足外科;承德醫(yī)學(xué)院附屬醫(yī)院創(chuàng)傷骨科;承德醫(yī)學(xué)院附屬醫(yī)院重癥醫(yī)學(xué)科;
【基金】：河北省2016年度醫(yī)學(xué)科學(xué)研究重點課題計劃(編號:20160010)
【分類號】：R658.1

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1 李克芳,程國玲,韓東景;斷肢再植術(shù)后病人夜間潛在問題的護理[J];中原醫(yī)刊;2004年09期

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本文編號：1536563