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我们腘动脉和腘下动脉损伤的手术结果:21例未行截肢手术。

Our Surgical Results in Popliteal and Infrapopliteal Artery Injuries: 21 Cases without Amputation.

作者信息

Tamteki N Burak, Gülsen Ersoy Güler

机构信息

Department of Cardiovascular Surgery, Faculty of Medicine, Kastamonu University, Kastamonu, Türkiye.

出版信息

Emerg Med Int. 2024 Jan 24;2024:1721047. doi: 10.1155/2024/1721047. eCollection 2024.

Abstract

OBJECTIVES

Popliteal and infrapopliteal artery injuries have significant morbidity and mortality rates, especially in terms of amputation. In our study, we aimed to evaluate patients who operated due to popliteal and infrapopliteal vascular injuries in our clinic. . Between 2016 and 2023; 21 patients who were operated in our clinic due to popliteal and infrapopliteal artery injuries were retrospectively evaluated.

RESULTS

2 of the patients were female (9.5%) and 19 were male (90.5%). Age ranges were 21-78. The causes of injury were gunshot wounds in 9 patients (42.86%), blunt trauma in 7 patients (33.33%), and sharp object injuries in 5 patients (23.80%). Reversed saphenous vein interposition in 7 patients (33.33%), primary repair in 6 patients (28.57%), 6 mm polytetrafluoroethylene graft (PTFE) interposition in 3 patients (14.28%), end-to-end anastomosis in 2 patients (9.52%), saphenous-PTFE composite graft interposition in 2 patients (9.52%), and embolectomy in 1 patient (4.76%) were performed. Arterial ligation was not performed. Simultaneous orthopedic intervention was performed in 8 patients. Fasciotomy was performed in 3 patients. Venous repair was performed in 5 patients with venous injuries. Vein ligation was not performed. Mortality was observed postoperatively in 1 patient. No patient developed amputation. Foot drop developed with nerve damage in 2 patients.

CONCLUSION

Mortality and morbidity rates may increase in popliteal and infrapopliteal artery injuries in cases of hemodynamic disorder, simultaneous bone fracture, multivessel injury, and nerve transection. These rates can be reduced by appropriate surgical repair and ensuring hemodynamic stability.

摘要

目的

腘动脉和腘以下动脉损伤具有较高的发病率和死亡率,尤其是在截肢方面。在我们的研究中,我们旨在评估在我们诊所因腘动脉和腘以下血管损伤而接受手术的患者。2016年至2023年期间,对21例在我们诊所因腘动脉和腘以下动脉损伤而接受手术的患者进行了回顾性评估。

结果

患者中2例为女性(9.5%),19例为男性(90.5%)。年龄范围为21 - 78岁。损伤原因包括9例枪伤(42.86%)、7例钝器伤(33.33%)和5例锐器伤(23.80%)。7例患者(33.33%)采用了大隐静脉倒置移植术,6例患者(28.57%)进行了一期修复,3例患者(14.28%)采用了6毫米聚四氟乙烯移植物(PTFE)移植术,2例患者(9.52%)进行了端端吻合术,2例患者(9.52%)采用了大隐静脉 - PTFE复合移植物移植术,1例患者(4.76%)进行了取栓术。未进行动脉结扎。8例患者同时进行了骨科干预。3例患者进行了筋膜切开术。5例有静脉损伤的患者进行了静脉修复。未进行静脉结扎。术后1例患者死亡。无患者发生截肢。2例患者因神经损伤出现足下垂。

结论

在血流动力学紊乱、同时存在骨折、多血管损伤和神经横断的情况下,腘动脉和腘以下动脉损伤的死亡率和发病率可能会增加。通过适当的手术修复和确保血流动力学稳定,可以降低这些发生率。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e94a/10830198/bfbec2262f8e/EMI2024-1721047.001.jpg

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