目的探討毒品注射所致感染性假性動(dòng)脈瘤的特點(diǎn)及治療方法與臨床療效。方法回顧性分析我院血管外科2009年1月至2010年6月期間收治的13例感染性假性動(dòng)脈瘤吸毒患者的臨床資料,采用切除瘤體及周圍炎性組織、瘤腔清創(chuàng)及動(dòng)脈結(jié)扎或人工血管置換術(shù),觀察移植效果及并發(fā)癥發(fā)生情況。結(jié)果13例手術(shù)均獲成功,無(wú)一例發(fā)生肢體壞死; 傷口一期愈合5例,二期愈合8例; 7例發(fā)生程度不等的淋巴瘺。隨訪2~12個(gè)月(平均7個(gè)月),其中1例術(shù)后2個(gè)月瘤腔下端感染形成膿腫伴出血,行切開(kāi)引流痊愈; 2例術(shù)后4個(gè)月人造血管感染行人造血管摘除,切口換藥痊愈; 有2例左肘部假性肱動(dòng)脈瘤直接行血管結(jié)扎,未用人工血管移植; 余8例復(fù)查B超顯示移植血管通暢,無(wú)血栓形成。結(jié)論徹底清創(chuàng)、血管移植、控制感染是治療感染性假性動(dòng)脈瘤的有效方法。
引用本文: 盧輝俊,趙翼,劉輝,胡亞立. 感染性假性動(dòng)脈瘤的外科診治體會(huì). 中國(guó)普外基礎(chǔ)與臨床雜志, 2011, 18(3): 333-335. doi: 復(fù)制
1. | 鄭江華, 陳開(kāi), 武國(guó), 等. 感染性股動(dòng)脈假性動(dòng)脈瘤的外科治療 [J]. 中國(guó)普外基礎(chǔ)與臨床雜志, 2009, 16(4): 296298. |
2. | Rabbani A, Moini M, Rasouli MR. Obturator bypass as an alternative technique for revascularization in patients with infected femoral pseudoaneurysms [J]. Arch Iran Med, 2008, 11(1): 5053. |
3. | 周翔字, 何延政, 袁平, 等. 注射毒品所致感染性假性動(dòng)脈瘤的血管重建17例 [J]. 中國(guó)修復(fù)重建外科雜志, 2005, 19(8): 632634. |
4. | 邱榮飛, 胡朝平. 股動(dòng)脈結(jié)扎清創(chuàng)引流治療股動(dòng)脈假性動(dòng)脈瘤感染破裂大出血 [J]. 實(shí)用臨床醫(yī)學(xué), 2010, 11(1): 7071. |
5. | Naqi SA, Khan HM, Akhtar S, et al. Femoral pseudoaneurysm in drug addicts-excision without revascularization is a viable option [J]. Eur J Vasc Endovasc Surg, 2006, 31(6): 585587. |
6. | Salimi J, Shojaeefar A, Khashayar P. Management of infected femoral pseudoaneurysms in intravenous drug abusers: a review of 57 cases [J]. Arch Med Res, 2008, 39(1): 120124. |
7. | 戴毅, 趙國(guó)剛, 孟敏, 等. 感染性假性動(dòng)脈瘤血管處理方式的選擇 [J]. 四川醫(yī)學(xué), 2010, 31(4): 443445. |
8. | Benjamin ME, Cohn EJ Jr, Purtill WA, et al. Arterial reconstruction with deep leg veins for the treatment of mycotic aneurysms [J]. J Vasc Surg, 1999, 30(6): 10041015. |
9. | Dighe S, Thomas P. Ruptured superficial femoral artery aneurysm treated by simple ligation [J]. Singapore Med J, 2008, 49(6): e151e152. |
10. | Klonaris C, Katsargyris A, Papapetrou A, et al. Infected femoral artery pseudoaneurysm in drug addicts: the beneficial use of the internal iliac artery for arterial reconstruction [J]. J Vasc Surg, 2007, 45(3): 498504.. |
11. | Georgiadis GS, Lazarides MK, Polychronidis A, et al. Surgical treatment of femoral artery infected false aneurysms in drug abusers [J]. ANZ J Surg, 2005, 75(11): 10051010. |
12. | 李英海, 姚燕丹, 林少芒. 毒品注射致動(dòng)脈假性動(dòng)脈瘤的治療體會(huì) [J]. 現(xiàn)代臨床醫(yī)學(xué)生物工程學(xué)雜志, 2006, 12(2): 210211.. |
13. | 朱通伯, 戴克戎. 骨科手術(shù)學(xué) [M]. 北京: 人民衛(wèi)生出版社, 1996: 1104.. |
- 1. 鄭江華, 陳開(kāi), 武國(guó), 等. 感染性股動(dòng)脈假性動(dòng)脈瘤的外科治療 [J]. 中國(guó)普外基礎(chǔ)與臨床雜志, 2009, 16(4): 296298.
- 2. Rabbani A, Moini M, Rasouli MR. Obturator bypass as an alternative technique for revascularization in patients with infected femoral pseudoaneurysms [J]. Arch Iran Med, 2008, 11(1): 5053.
- 3. 周翔字, 何延政, 袁平, 等. 注射毒品所致感染性假性動(dòng)脈瘤的血管重建17例 [J]. 中國(guó)修復(fù)重建外科雜志, 2005, 19(8): 632634.
- 4. 邱榮飛, 胡朝平. 股動(dòng)脈結(jié)扎清創(chuàng)引流治療股動(dòng)脈假性動(dòng)脈瘤感染破裂大出血 [J]. 實(shí)用臨床醫(yī)學(xué), 2010, 11(1): 7071.
- 5. Naqi SA, Khan HM, Akhtar S, et al. Femoral pseudoaneurysm in drug addicts-excision without revascularization is a viable option [J]. Eur J Vasc Endovasc Surg, 2006, 31(6): 585587.
- 6. Salimi J, Shojaeefar A, Khashayar P. Management of infected femoral pseudoaneurysms in intravenous drug abusers: a review of 57 cases [J]. Arch Med Res, 2008, 39(1): 120124.
- 7. 戴毅, 趙國(guó)剛, 孟敏, 等. 感染性假性動(dòng)脈瘤血管處理方式的選擇 [J]. 四川醫(yī)學(xué), 2010, 31(4): 443445.
- 8. Benjamin ME, Cohn EJ Jr, Purtill WA, et al. Arterial reconstruction with deep leg veins for the treatment of mycotic aneurysms [J]. J Vasc Surg, 1999, 30(6): 10041015.
- 9. Dighe S, Thomas P. Ruptured superficial femoral artery aneurysm treated by simple ligation [J]. Singapore Med J, 2008, 49(6): e151e152.
- 10. Klonaris C, Katsargyris A, Papapetrou A, et al. Infected femoral artery pseudoaneurysm in drug addicts: the beneficial use of the internal iliac artery for arterial reconstruction [J]. J Vasc Surg, 2007, 45(3): 498504..
- 11. Georgiadis GS, Lazarides MK, Polychronidis A, et al. Surgical treatment of femoral artery infected false aneurysms in drug abusers [J]. ANZ J Surg, 2005, 75(11): 10051010.
- 12. 李英海, 姚燕丹, 林少芒. 毒品注射致動(dòng)脈假性動(dòng)脈瘤的治療體會(huì) [J]. 現(xiàn)代臨床醫(yī)學(xué)生物工程學(xué)雜志, 2006, 12(2): 210211..
- 13. 朱通伯, 戴克戎. 骨科手術(shù)學(xué) [M]. 北京: 人民衛(wèi)生出版社, 1996: 1104..