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静脉药物滥用者感染性股动脉假性动脉瘤的治疗:57例病例回顾

Management of infected femoral pseudoaneurysms in intravenous drug abusers: a review of 57 cases.

作者信息

Salimi Javad, Shojaeefar Abulfazl, Khashayar Patricia

机构信息

Subspecialties in Vascular Surgery, Sina Trauma and Surgery Research Center, Sina Hospital, Tehran University of Medical Sciences, Tehran, Iran.

出版信息

Arch Med Res. 2008 Jan;39(1):120-4. doi: 10.1016/j.arcmed.2007.07.004. Epub 2007 Sep 29.

Abstract

BACKGROUND

The present study was carried out to evaluate the clinical characteristics and surgical methods used for the management of infected femoral pseudoaneurysms secondary to illegal drug injections.

METHODS

Fifty seven consecutive patients who presented with infected pseudoaneurysm of the lower limb and were admitted to the emergency department of Sina Hospital during a 5-year period were enrolled in this study. Surgical methods performed consisted of vein angioplasty, simple ligation of femoral artery, and emergent or delayed revascularization.

RESULTS

All participating patients were males with a mean age of 36.7 years. Three (5.3%) and two (3.5%) patients underwent primary repair and emergent vascular bypass, respectively; whereas delayed revascularization was performed in only eight (14%) cases. Forty four (77.2%) patients achieved a normal lifestyle without any vascular bypass. Early critical ischemia and late claudication was reported in two (3.5%) and eight (14%) patients, respectively. Other complications such as amputation and mortality were rarely reported.

CONCLUSIONS

In our study, simple ligation of the external iliac or femoral artery was the most frequent management method for treating infected femoral pseudoaneurysms. Simple ligation of the external iliac or femoral artery seems to be a safe procedure in drug abusers presenting with infected femoral pseudoaneurysms.

摘要

背景

本研究旨在评估因非法药物注射继发感染性股动脉假性动脉瘤的临床特征及手术治疗方法。

方法

本研究纳入了5年间连续收治于新浪医院急诊科的57例下肢感染性假性动脉瘤患者。所采用的手术方法包括静脉血管成形术、股动脉单纯结扎术以及急诊或延迟血管重建术。

结果

所有参与研究的患者均为男性,平均年龄36.7岁。分别有3例(5.3%)和2例(3.5%)患者接受了一期修复和急诊血管搭桥手术;而仅8例(14%)患者进行了延迟血管重建术。44例(77.2%)患者无需进行任何血管搭桥手术即可恢复正常生活。分别有2例(3.5%)和8例(14%)患者出现早期严重缺血和晚期跛行。其他并发症如截肢和死亡则鲜有报道。

结论

在我们的研究中,髂外动脉或股动脉单纯结扎术是治疗感染性股动脉假性动脉瘤最常用的治疗方法。对于出现感染性股动脉假性动脉瘤的药物滥用者,髂外动脉或股动脉单纯结扎术似乎是一种安全的手术方法。

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