摘要
目的探讨抢救下腔静脉损伤安全有效的治疗方法,提高抢救成功率。方法 2000年1月至2008年3月湖北省咸宁市中心医院心胸外科在应用体外循环技术支持下修复下腔静脉损伤10例,其中男7例,女3例,年龄18～47岁,平均(31±12.2)岁。肝上下腔静脉损伤3例,肝后下腔静脉损伤6例,肝下下腔静脉损伤1例;手术医源性损伤3例,腹部外伤致使肝创伤性损伤7例;升主动脉+股静脉插管6例,升主动脉+股静脉+上腔静脉插管4例;均采用胸骨正中切口,浅低温心脏空跳下修补破损腔静脉9例,心脏灌注冷晶停跳液1例。破损均采用心包片修补。结果腹部切口感染2例,胆汁漏合并肝周感染2例,二次开腹止血2例,肝功能不全1例。术后死亡1例,其余9例痊愈。随访1～8年,修补损伤的下腔静脉无畸形、狭窄、血栓形成。结论体外循环技术可为紧急抢救下腔静脉损伤提供安全、有效的技术支持,可最大限度避免心脏骤停和循环衰竭,提高了抢救成功率。
Objective To provide an effective method for treatment of inferior vena cava injury and enhance the successful rate.Methods To summarize the clinical date of 10 patients with inferior vena cava injury from January 2000 to Mach 2008.All of 10 patents were underwent procedure with Cardiopulmonary bypass technique under mild hypothermia and went through sternal incision.All were repaired with pericardium piece.seven cases were male,three cases female and the mean age was 31±12.2.Years.Three cases were in suprahepatic vena cava injury,six cases were in retro hepatic and one case was in infrahepatic.Three were iatrogenic injury,seven were liver trauma.Results Died 1 in post operation,the others were cured and mortality rate 10%.Complications：abdominal incision infection 2,gall leakage with infection 2.hepatic insufficiency 1.All patents were followed-up for 1-8 years and have not been found with vascular malformation,thrombus and narrow.Conclusion Cardiopulmonary bypass technique is a safe and effective method for treatment of inferior vena cava injury and it avoid heart arrest and circulatory failure.
出处
《中国实用外科杂志》
CSCD
北大核心
2010年第12期1042-1043,共2页
Chinese Journal of Practical Surgery
关键词
体外循环
下腔静脉
创伤和损伤
cardiopulmonary bypass
inferior vena cava
trauma and injury
