DSA联合双腔Fogarty导管在断肢再植术后动脉危象中的应用

发布时间：2018-02-26 04:36

本文关键词： 数字减影血管造影 Fogarty导管离断肢体再植术动脉危象　出处：《广东医学》2017年20期 　论文类型：期刊论文

【摘要】：目的观察DSA联合双腔Fogarty导管在断肢再植术后动脉危象中应用的临床疗效。方法 DSA联合双腔Fogarty导管用于断肢再植术后动脉危象的患者19例,术后17例顺利成活,切口均Ⅰ期愈合,其中1例出现急性肝功能损害,予以内科综合治疗,急性肝功能损害纠正,1例出现骨筋膜室综合征,行手术切开治疗,恢复良好。术后2例再次出现动脉危象,行切开探查术,1例治疗成功,1例动脉闭塞,肢体部分坏死,行截肢术。结果所有病例未发生血管穿孔、伤口感染等并发症。血栓存在于动脉内,长度为0.8~4.5 cm。排除切开探查术的2例患者,采用Fogarty导管处理的17例患者,平均随访13个月(9~36个月),肢体血运良好,皮温正常,感觉改善,活动度改善。参照中华医学会手外科学分会断肢再植功能评定试用标准评价疗效,本组优10例、良4例、差3例,优良率82.3%。结论应用DSA联合双腔Fogarty球囊导管处理断肢再植术后动脉危象,可避免断端修复区域二次损伤,临床效果满意。
[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.
【作者单位】：承德医学院附属医院手足外科;承德医学院附属医院创伤骨科;承德医学院附属医院重症医学科;
【基金】：河北省2016年度医学科学研究重点课题计划(编号:20160010)
【分类号】：R658.1

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