Iriz Erkan, Erer Dilek, Kula Serdar, Olgunturk Rana, Halit Velit
Department of Cardiovascular Surgery, Gazi University.
Circ J. 2007 Apr;71(4):554-8. doi: 10.1253/circj.71.554.
To evaluate the use and advantage of microsurgical intervention and intravenous iloprost administration in delayed infantile artery injuries.
Four patients were followed up and treated in our clinic between June 2003 and June 2006 for infantile artery injuries and distal ischemia. The average age of the 4 infants (3 girls, 1 boy) was 134.7+/-33.6 days. The reason for all of the artery injuries was iatrogenic. Tissue necrosis started in patches in 2 babies who were admitted at the 12(th) hour after ischemia (19(th) and 22(nd) hours), and therefore the artery was repaired by microsurgery. Iloprost infusion was also used in addition to the conservative treatments. The other 2 patients were assessed before the first 12 h after distal ischemia and were treated by iloprost without any surgical intervention. None of the patients lost any tissue or extremities during the 9 months (average) follow-up time. One of our patients died following the ventricular septal defect repair at the 9(th) month after a successful repair of artery.
We believe that intravenous iloprost infusion is very effective in the treatment of distal ischemia when used in addition to the conservative treatment methods for artery injuries in infants.
评估显微外科干预和静脉注射伊洛前列素在小儿动脉损伤延迟治疗中的应用及优势。
2003年6月至2006年6月期间，我们诊所对4例小儿动脉损伤和远端缺血患者进行了随访和治疗。4例婴儿（3例女孩，1例男孩）的平均年龄为134.7±33.6天。所有动脉损伤均为医源性。2例在缺血后12小时（第19和22小时）入院的婴儿出现散在组织坏死，因此通过显微外科手术修复动脉。除保守治疗外，还使用了伊洛前列素输注。另外2例患者在远端缺血后12小时内接受评估，未进行任何手术干预，仅接受伊洛前列素治疗。在平均9个月的随访期内，所有患者均未出现组织或肢体丢失。其中1例患者在动脉成功修复后第9个月因室间隔缺损修复手术死亡。
我们认为，对于婴儿动脉损伤，在保守治疗方法基础上联合静脉注射伊洛前列素输注治疗远端缺血非常有效。
