摘要
目的探讨高能量外伤致膝关节周围闭合性骨折伴股()动脉损伤的诊断及处理原则。方法本组37例病人分别系膝关节周围如股骨髁上、股骨髁间、胫骨近端骨折伴股()动脉损伤,分别于不同时间探查吻合血管,部分血管缺损2cm以上者采用自体大隐静脉或人工血管移植修复血管。结果37例患者均获得6个月以上的随访,6例外伤后超过48h再探查吻合血管者高位截肢;5例外伤后超过24h再探查吻合血管者患肢功能大部丧失或足部坏死;24例外伤后8h以内吻合血管者功能恢复良好;2例虽在8h以内吻合血管,但均系多发伤昏迷患者,继发骨筋膜室挤压综合征导致缺血性肌挛缩。结论高能量外伤所致闭合性膝关节周围骨折应高度警惕股()动、静脉损伤,早期明确诊断,尽早恢复肢体血液循环是挽救肢体的关键。
Objective To study the diagnosis and treatment of femeral （popliteal） artery injury principle in patients with closed fracture near knee joint caused by high energy wound, netheds 37 cases of femoral （popliteal） artery injury associated with fracture near articulatio genus complicated were rewiewed. The injured arteries were explored and anastomosed in different time. Autogenous vein or prosthetic materials were performed when the vascular injury was longer than 2 cm. Results All cases were followed up over 6 months. 6 cases suffered amputations in high position because of over 48 hours from injury to exploration. 5 cases lost most functions of their wounded legs because of over 24 hours, 24 cases who were treated in 8 hours have well recovery of function. 2 cases with multiple injuries and coma occurred compartnent syndrome although Injuried artery were anastomosecl within 8 hours, Conclusion Femoral（ Popliteal） Artery Injury should be noticed in patients with closed fractures near knee joint caused by high energy wound, Early definite diagnosis and restore the blood circulation play an important role in saving the wounded legs.
出处
《浙江临床医学》
2005年第8期793-794,共2页
Zhejiang Clinical Medical Journal
