• 中國醫(yī)科大學(xué)附屬第一醫(yī)院普通外科教研室、血管甲狀腺外科(沈陽 110001);

目的  探討肢體假性動脈瘤的病因、發(fā)病機(jī)理以及手術(shù)方式的選擇,評價各種手術(shù)的治療效果,以提高對假性動脈瘤的診治水平。
方法  30例假性動脈瘤患者(股動脈18例,腘動脈7例,肱動脈2例,橈動脈3例),其中8例為感染或破裂性假性動脈瘤,1例肢體壞死。30例患者均行外科手術(shù)治療,其中11例行假性動脈瘤破口修補(bǔ)術(shù),2例行股動脈結(jié)扎術(shù),2例行血管端端吻合術(shù),8例行自體大隱靜脈移植術(shù),6例行人工血管移植術(shù),1例行截肢術(shù)。
結(jié)果  30例患者術(shù)后恢復(fù)順利,除1例行下肢截肢術(shù)外,其余29例術(shù)后效果良好。隨訪7個月~8年,平均(4.4±2.3)年; 行人工血管移植術(shù)者4例移植段發(fā)生血栓,經(jīng)溶栓治療后好轉(zhuǎn),其余血供狀況良好。
結(jié)論  外科手術(shù)治療肢體假性動脈瘤是一種有效的方法。

引用本文: 徐健,陳建華,馬文鋒,張健,段志泉,辛世杰. 肢體假性動脈瘤的臨床診治(附30例報道). 中國普外基礎(chǔ)與臨床雜志, 2009, 16(10): 845-846. doi: 復(fù)制

1. Perez-Cruet MJ, Patwardhan RV, Mawad ME, et al. Treatment of dissecting pseudoaneurysm of the cervical internal carotid artery using a wall stent and detachable coils: case report [J]. Neurosurgery, 1997; 40(3): 622-625.
2. Sedwitz MM, Hye RJ, Stabile BE. The changing epidemiology of pseudoaneurysm. Therapeutic implications [J]. Arch Surg, 1988; 123(4): 473-476.
3. 劉正軍, 汪忠鎬. 醫(yī)源性假性動脈瘤的診治 [J]. 中華外科雜志, 1998; 36(2): 91-92.
4. Gareis R. Nonsurgical therapy of iatrogenic aneurysm spurium [J]. Dtsch Med Wochenschr, 2003; 128(13): 688.
5. Lin PH, Dodson TF, Bush RL, et al. Surgical intervention for complications caused by femoral artery catheterization in pediatric patients [J]. J Vasc Surg, 2001; 34(6): 1071-1078.
6. 陳潤祥, 邵磊. 醫(yī)源性假性動脈瘤的臨床分析 [J]. 醫(yī)藥論壇雜志, 2005; 26(21): 31-32.
7. Tsao JW, Marder SR, Goldstone J, et al. Presentation, diagnosis, and management of arterial mycotic pseudoaneurysms in injection drug users [J]. Ann Vasc Surg, 2002; 16(5): 652-662.
8. Manekeller S, Tolba RH, Schroeder S, et al. Analysis of vascular complications in intra-venous drug addicts after puncture of femoral vessels [J]. Zentralbl Chir, 2004; 129(1): 21-28.
9. Schwartz RA, Kerns DB, Mitchell DG. Color Doppler ultrasound imaging in iatrogenic arterial injuries [J]. Am J Surg, 1991; 162(1): 4-8.
10. Múnera F, Soto JA, Palacio DM, et al. Penetrating neck injuries: helical CT angiography for initial evaluation [J]. Radiology, 2002; 224(2): 366-372.
11. Ramsay DW, McAuliffe W. Traumatic pseudoaneurysm and high flow arteriovenous fistula involving internal jugular vein and common carotid artery. Treatment with covered stent and embolization [J]. Australas Radiol, 2003; 47(2): 177-180.
12. 楊謙, 楊輝, 吳剛, 等. 17例假性動脈瘤的外科治療 [J]. 中國微創(chuàng)外科雜志, 2007; 7(12): 1227-1228.
13. 陳力, 陳華, 田華, 等. 假性動脈瘤的臨床診治 [J]. 中華全科醫(yī)師雜志, 2004; 3(1): 68.
14. 呂建彪, 馬烈, 胡愛蓮. 周圍性假性動脈瘤的外科治療 [J].實(shí)用臨床醫(yī)學(xué), 2006; 7(10): 114-115.
15. 鄭江華, 陳開, 武國, 等. 感染性股動脈假性動脈瘤的外科治療 [J]. 中國普外基礎(chǔ)與臨床雜志, 2009; 16(4): 296-299.
16. 倪良宏, 郭勁松, 唐軍建, 等. 四肢動脈損傷診治體會 [J]. 中國普外基礎(chǔ)與臨床雜志, 2007; 14(6): 705-706.
17. 方偉, 郭曙光, 陳翠菊, 等. 毒品注射致假性動脈瘤急性破裂出血的處理經(jīng)驗(yàn) [J]. 中國普外基礎(chǔ)與臨床雜志, 2006; 13(4): 452-453.
18. 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): 585-587.
19. Li JW, Wang SM, Chen XD. Management of femoral artery pseudoaneurysm due to addictive drug injection [J]. Chin J Traumatol, 2004; 7(4): 244-246.
  1. 1. Perez-Cruet MJ, Patwardhan RV, Mawad ME, et al. Treatment of dissecting pseudoaneurysm of the cervical internal carotid artery using a wall stent and detachable coils: case report [J]. Neurosurgery, 1997; 40(3): 622-625.
  2. 2. Sedwitz MM, Hye RJ, Stabile BE. The changing epidemiology of pseudoaneurysm. Therapeutic implications [J]. Arch Surg, 1988; 123(4): 473-476.
  3. 3. 劉正軍, 汪忠鎬. 醫(yī)源性假性動脈瘤的診治 [J]. 中華外科雜志, 1998; 36(2): 91-92.
  4. 4. Gareis R. Nonsurgical therapy of iatrogenic aneurysm spurium [J]. Dtsch Med Wochenschr, 2003; 128(13): 688.
  5. 5. Lin PH, Dodson TF, Bush RL, et al. Surgical intervention for complications caused by femoral artery catheterization in pediatric patients [J]. J Vasc Surg, 2001; 34(6): 1071-1078.
  6. 6. 陳潤祥, 邵磊. 醫(yī)源性假性動脈瘤的臨床分析 [J]. 醫(yī)藥論壇雜志, 2005; 26(21): 31-32.
  7. 7. Tsao JW, Marder SR, Goldstone J, et al. Presentation, diagnosis, and management of arterial mycotic pseudoaneurysms in injection drug users [J]. Ann Vasc Surg, 2002; 16(5): 652-662.
  8. 8. Manekeller S, Tolba RH, Schroeder S, et al. Analysis of vascular complications in intra-venous drug addicts after puncture of femoral vessels [J]. Zentralbl Chir, 2004; 129(1): 21-28.
  9. 9. Schwartz RA, Kerns DB, Mitchell DG. Color Doppler ultrasound imaging in iatrogenic arterial injuries [J]. Am J Surg, 1991; 162(1): 4-8.
  10. 10. Múnera F, Soto JA, Palacio DM, et al. Penetrating neck injuries: helical CT angiography for initial evaluation [J]. Radiology, 2002; 224(2): 366-372.
  11. 11. Ramsay DW, McAuliffe W. Traumatic pseudoaneurysm and high flow arteriovenous fistula involving internal jugular vein and common carotid artery. Treatment with covered stent and embolization [J]. Australas Radiol, 2003; 47(2): 177-180.
  12. 12. 楊謙, 楊輝, 吳剛, 等. 17例假性動脈瘤的外科治療 [J]. 中國微創(chuàng)外科雜志, 2007; 7(12): 1227-1228.
  13. 13. 陳力, 陳華, 田華, 等. 假性動脈瘤的臨床診治 [J]. 中華全科醫(yī)師雜志, 2004; 3(1): 68.
  14. 14. 呂建彪, 馬烈, 胡愛蓮. 周圍性假性動脈瘤的外科治療 [J].實(shí)用臨床醫(yī)學(xué), 2006; 7(10): 114-115.
  15. 15. 鄭江華, 陳開, 武國, 等. 感染性股動脈假性動脈瘤的外科治療 [J]. 中國普外基礎(chǔ)與臨床雜志, 2009; 16(4): 296-299.
  16. 16. 倪良宏, 郭勁松, 唐軍建, 等. 四肢動脈損傷診治體會 [J]. 中國普外基礎(chǔ)與臨床雜志, 2007; 14(6): 705-706.
  17. 17. 方偉, 郭曙光, 陳翠菊, 等. 毒品注射致假性動脈瘤急性破裂出血的處理經(jīng)驗(yàn) [J]. 中國普外基礎(chǔ)與臨床雜志, 2006; 13(4): 452-453.
  18. 18. 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): 585-587.
  19. 19. Li JW, Wang SM, Chen XD. Management of femoral artery pseudoaneurysm due to addictive drug injection [J]. Chin J Traumatol, 2004; 7(4): 244-246.