毒品注射致股动脉假性动脉瘤破裂出血的诊治
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苏旭 E-mail:suxu@sina.com

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Ruptured femoral artery pseudoaneurysm due to drug injection
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    摘要:

    目的:探讨注射毒品引起股动脉假性动脉瘤形成并破裂出血的诊断与治疗方法。
    方法:回顾性分析2003年3月—2009年12月收治的22例因反复注射毒品致股动脉假性动脉瘤形成并破裂出血患者的临床资料。
    结果:22例患者均接受手术治疗,术中行瘤体切除、清创后,8例行股动脉破口修补术;4例行破口两侧股动脉结扎术;10例行髂外动脉-股动脉人工血管移植术。22例均手术成功,手术后早期出现人工血管与股动脉吻合口破裂出血1例,急诊手术重新吻合,随后出现切口感染,经换药后切口愈合。术后患侧下肢功能均好。随访6个月至7年,平均3年。1例患者术后2年出现人工血管感染,1例出院后14 d发生吻合口出血,均经再次血管吻合治愈;2例股动脉结扎患者遗留轻间歇性跛行。
    结论:治疗股动脉假性动脉瘤形成并破裂出血的手术方式,以股动脉假性动脉瘤切除+清创+股动脉修补术最为简单、安全有效;人工血管移植术疗效确定,能最大限度保证患肢血供;股动脉修补或结扎术在选择病例中也是有效的治疗方法。

    Abstract:

    Objective:To investigate the diagnosis and treatment methods of ruptured femoral artery psudoaneurysm caused by drug injection.
    Methods:A retrospective analysis of the clinical data of 22 cases of ruptured femoral artery false psudoaneurysm caused by drug injection and treated from March 2003 to February 2009 was conducted. 
    Results:All patients underwent operation. After excision of the aneurysm and debridement, 8 cases had repair of the femoral artery rupture, 4 cases were additionally treated by proximal and distal ligation of femoral artery, and 10 had proximal and distal ligation of the ruptured artary and prosthetic interposition graft between external iliac and femoral arteries. The  lower extremities of all the patients were successfully saved. During 6 months to 7 years follow up, 1 patient occurred graft infection, 1 had vassel anastomrostic bleeding, both were cured by reoperation; and 2 cases of argery ligation had mild intermittent claudication.
    Conclusions:Excision of pseudoaneurysm, local debridement and repair of the rupture is the simplest and safest method to treat rupture of femoral artery pseudoaneurysm. Prosthetic graft is an effective operation to maximally save the blood supply for the affected extremity. Ligation of the femoral artery is also an effective and safe method to cure the disease in selected patients.

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苏旭|李滨.毒品注射致股动脉假性动脉瘤破裂出血的诊治[J].中国普通外科杂志,2010,19(12):1271-1273.
DOI:10.7659/j. issn.1005-6947.2010.12.003

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  • 收稿日期:2010-07-12
  • 最后修改日期:2010-10-14
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  • 在线发布日期: 2010-12-15