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find Keyword "假性动脉瘤" 27 results
  • 注射毒品致股动脉假性动脉瘤破溃感染的治疗

    目的 总结注射毒品致股动脉假性动脉瘤破溃感染的外科治疗方法。方法 1994年3月~2004年10月,共收治因毒品注射致股动脉假性动脉瘤形成并破溃感染患者17例。男15例,女2例;年龄18~45岁。吸毒史2个月~10年,静脉注射史吸毒2~15个月,皮肤坏死1~6个月。皮肤坏死直径2~5cm,B超示包块大小15cm×10cm×8cm~18cm×13cm×10cm。急诊手术4例,择期手术13例。3例行人造血管移植,5例行远近端血管结扎,5例行静脉移植,2例动脉裂口直接缝合,2例行股深动脉移植。结果 术后可触及足背动脉搏动恢复2例,增强3例。切口Ⅰ期愈合6例,Ⅱ期愈合8例,3例出现伤口感染。15例获随访3~18个月,2例同侧大隐静脉远端移植及2例人造血管移植者经B超检查示移植血管栓塞,5例血管腔(1例人造血管、2例自体静脉移植、2例动脉裂口直接缝合)变狭窄。随访者均基本恢复正常生活。结论 注射毒品致股动脉假性动脉瘤形成并破溃感染患者,需手术治疗,争取择期手术,针对假性动脉瘤破溃时间超过1个月者,可考虑行远近端血管结扎术。

    Release date:2016-09-01 09:20 Export PDF Favorites Scan
  • 覆膜支架治疗难治性股动脉假性动脉瘤的探讨

    目的探讨覆膜支架置入治疗难治性股动脉假性动脉瘤的有效性及其安全性。方法2012 年 8 月至 2017 年 8 月期间,河西学院附属张掖人民医院血管外科共收治了 26 例难治性股动脉假性动脉瘤患者,其中属外伤性股动脉假性动脉瘤 20 例,医源性股动脉假性动脉瘤 6 例;26 例中有 8 例合并股动-静脉瘘。26 例患者术前全部经彩超检查得以确诊,并在彩超引导下进行常规压迫或瘤腔内注射血凝酶治疗,但均未获成功,26 例患者最终改行股动脉覆膜支架置入术治疗,其中 4 例同期行血肿清除术,2 例行假性动脉瘤腔内穿刺引流术。结果全部患者一期置入覆膜支架均获成功,股动脉假性动脉瘤及动-静脉瘘均治愈,6 例患者股深动脉封闭,无手术死亡及严重并发症发生。术后 6 个月及 12 个月进行随访,26 例患者均无瘤体复发及支架移位、断裂、栓塞和内瘘发生。结论覆膜支架置入治疗难治性股动脉假性动脉瘤是安全、有效、微创的方法,其短期效果满意,远期疗效有待进一步观察。

    Release date:2019-06-26 03:20 Export PDF Favorites Scan
  • Experience of Infected Pseudoaneurysms of Femoral Artery Caused by Drug Injection

    目的探讨毒品注射所致感染性假性动脉瘤的特点及治疗方法与临床疗效。方法回顾性分析我院血管外科2009年1月至2010年6月期间收治的13例感染性假性动脉瘤吸毒患者的临床资料,采用切除瘤体及周围炎性组织、瘤腔清创及动脉结扎或人工血管置换术,观察移植效果及并发症发生情况。结果13例手术均获成功,无一例发生肢体坏死; 伤口一期愈合5例,二期愈合8例; 7例发生程度不等的淋巴瘘。随访2~12个月(平均7个月),其中1例术后2个月瘤腔下端感染形成脓肿伴出血,行切开引流痊愈; 2例术后4个月人造血管感染行人造血管摘除,切口换药痊愈; 有2例左肘部假性肱动脉瘤直接行血管结扎,未用人工血管移植; 余8例复查B超显示移植血管通畅,无血栓形成。结论彻底清创、血管移植、控制感染是治疗感染性假性动脉瘤的有效方法。

    Release date:2016-09-08 04:25 Export PDF Favorites Scan
  • The diagnostic value of CT angiography in traumatic pelvic artery pseudoaneurysm and dissecting aneurysm

    Objective To discuss the clinical application value of CT angiography (CTA) in traumatic pelvic artery pseudoaneurysm and dissecting aneurysm. Methods A total of 8 patients including 7 with traumatic pelvic artery pseudoaneurysm and 1 with dissecting aneurysm diagnosed by CTA in Suining Central Hospital from August 2012 to January 2016 were enrolled in this study, in whom 6 patients with traumatic pseudoaneurysm treated with embolotherapy were confirmed by digital subtraction angiography. Image post-processing techniques of CTA including curve planar reformation, multiplanar reconstruction and volume rendering were used. Results In the seven patients diagnosed as solitary traumatic pelvic artery pseudoaneurysm by CTA, 3 had superior gluteal artery pseudoaneurysm, 2 had inferior gluteal artery pseudoaneurysm, and 2 had external iliac artery pseudoaneurysm. The 7 pseudoaneurysms were pouch-shaped with the short diameters ranged from 9 to 64 mm and the long diameters ranged from 11 to 78 mm. Six locations of artery laceration were displayed clearly, thereinto 1 case was combined with arteriovenous fistula. In addition, a vessel occlusion caused by the limitation of right external iliac artery dissecting aneurysm and the thrombosis in left side of the external iliac artery was found in 1 case. Conclusions As a non-invasive diagnostic technique, CTA can accurately diagnose traumatic pelvic artery pseudoaneurysm and dissecting aneurysm, clearly display the location relationship of pseudoaneurysm and its parent artery, and find whether arteriovenous fistula exists. Beyond that, the true and false lumen of dissecting aneurysm can be precisely identified by this technique. CTA can provide important image information for formulating individual treatment plan.

    Release date:2017-10-27 11:09 Export PDF Favorites Scan
  • Application of MRA and DSA on Diagnosis of Traumatic Pseudoaneurysm and Arteriovenous Fistula (Report of 1 Case)

    目的 提高对创伤性假性动脉瘤并动静脉瘘的影像诊断水平。 方法 报告1例腰椎间盘手术所致的创伤性假性动脉瘤并动静脉瘘,比较分析MRA和DSA对该病的诊断价值。 结果 MRA能够明确创伤性假性动脉瘤及动静脉瘘的诊断,与DSA有良好的相关性。 结论 MRA对创伤性假性动脉瘤并动静脉瘘的确诊有重要价值,在一定程度上能够代替常规血管造影。

    Release date:2016-08-28 04:43 Export PDF Favorites Scan
  • 外伤性主动脉弓部破裂巨大假性动脉瘤形成腔内修复术一例

    Release date:2016-08-30 05:45 Export PDF Favorites Scan
  • EFFECTIVENESS COMPARISON BETWEEN ENDOVASCULAR RECANALIZATION AND OPEN SURGICAL REVASCULARIZATION TO TREAT PERIPHERAL PSEUDOANEURYSM

    Objective To compare the effectiveness, complications, and follow-up results between endovascular recanalization (EVR) and open surgical revascularization (OSR) in the treatment of peripheral pseudoaneurysm, so as to provide a reference for choosing a appropriate surgical procedure. Methods Clinical data of 62 cases of peripheral pseudoaneurysm between January 2001 and January 2012 were analyzed retrospectively. EVR was performed in 28 patients (EVR group) and OSR in 34 patients (OSR group). There was no significant difference in gender, age, cause of injury, tumor location, and diameter of tumor between 2 groups (P gt; 0.05). Results The operation time, blood loss, ICU monitoring time, and hospitalization time in EVR group were significantly shorter than those in OSR group (P lt; 0.05). In OSR group, 12 cases (35.29%) had early postoperative complications, including 2 deaths due to acute respiratory distress syndrome, 5 cases of pulmonary infection, 3 cases of wound infection, and 2 cases of deep vein thrombosis; in EVR group, 2 cases (7.14%) had early postoperative complications, including 1 case of hematoma at puncture site and 1 case of thrombosis in stent. There was significant difference in early postoperative complication incidence between 2 groups (χ2=6.691, P=0.008). The patients were followed up 12-39 months (mean, 26 months). In OSR and EVR groups after operation, the patency rates of the reconstructed vessels were 96.88% (31/32) and 92.86% (26/28) respectively at 12 months, showing no significant difference (χ2=0.014, P=0.905); the patency rates were 89.29% (25/28) and 84.00% (21/25) respectively at 24 months, showing no significant difference (χ2=0.322, P=0.570). Conclusion Compared with OSR, EVR is a minimally invasive, safe, and effective therapy for peripheral pseudoaneurysm with the advantages of less bleeding, shorter hospitalization time, and less complications. Long-term effectiveness still needs further observation, and patients have to take antiplatelet drugs for long time after EVR.

    Release date:2016-08-31 04:07 Export PDF Favorites Scan
  • IgG4 sclerosing cholangitis misdiagnosed as hilar cholangiocarcinoma and MDT discussion on postoperative gastrointestinal hemorrhage

    ObjectiveTo explore clinical manifestation, diagnosis and treatment of IgG4 sclerosing cholangitis developed postoperative gastroduodenal hemorrhage, so as to improve awareness and treatment of this disease. MethodThe clinical data of a case of IgG4 sclerosing cholangitis misdiagnosed as the hilar cholangiocarcinoma which developed postoperative gastrointestinal hemorrhage in this hospital were analyzed retrospectively. ResultsThis patient was misdiagnosed as the hilar cholangiocarcinoma and accepted the radical resection, while the postoperative pathology proved to be the IgG4 sclerosing cholangitis. One month later, the patient developed the acute gastrointestinal hemorrhage and it was resolved by using the endovascular embolization. ConclusionsPreoperative distinguishing IgG4 sclerosing cholangitis from hilar cholangiocarcinoma can avoid an unnecessary surgery. Endovascular intervention is both a useful measure of diagnosis and treatment for gastroduodenal pseudoaneurysm. Attention should be paid to arterial protection during process of arterial osteogenesis in hepatobiliary operation.

    Release date:2019-01-16 10:05 Export PDF Favorites Scan
  • REPAIR AND RECONSTRUCTION OF INFECTIVE FEMORAL FALSE ANEURYSM CAUSED BY DRUG INJECTION

    Objective To summarize the revascularization method of infective femoral false aneurysm caused by drug injection. Methods Between November 2003 and May 2009, 84 patients with infective femoral false aneurysm caused by drug injection were treated, and the cl inical data were analysed retrospectively. There were 67 males and 17 females with anaverage age of 34.6 years (range, 19-51 years). The average duration of drug injection was 2.7 years (range, 1-11 years). In 13 cases, the defect of femoral artery was 3-10 cm; defect ranged from 1.0 cm × 0.3 cm to 3.0 cm × 0.7 cm in the others. The surgical treatment included bypass using synthetic grafts in 5 cases, great saphenous veins transplantation in 29 cases, repair of femoral artery in 24 cases, and l igation of femoral artery in 26 cases. Results Two cases died of intraoperative pulmonary embol ism. Eight cases had postoperative wound infection, which was cured after changing dressings. Incisions healed by first intention in the other paitents. A total of 82 cases were followed up 12-36 months (mean, 17.3 months). In 56 patients undergoing artery reconstruction or repair, dorsal pedis artery pulse was significantly improved, and no distal osteofascial compartment syndrome occurred. In 26 patients undergoing femoral artery l igation, angiography at 1 week after operation showed abundant collateral circulation from ipsilateral internal il iac artery, superior gluteal artery or contralateral internal il iac artery. Three cases had postoperative intermittent claudication which was improved after symptomatic treatment. Conclusion Infective femoral false aneurysm caused by drug injection should be treated surgerically as early as possible, and effective treatments include debridement, drainage, defect repair or bypass with synthetic graft or great saphenous vein from homonymy external il iac artery to superficial femoral artery. Ligation of femoral artery is an option in patients with serious infection when revascularization is impossible.

    Release date:2016-08-31 05:44 Export PDF Favorites Scan
  • Effectiveness evaluation of systematic clinical management for femoral pseudoaneurysm after interventional treatment under doctor-nurse integration mode

    Objective To carry out the systematic clinical management to reduce the incidence of femoral pseudoaneurysm after interventional treatment. Methods A historical controlled study was used to compare the management effect before (from October 2012 to October 2013) and after (from March 2014 to March 2015) the application of doctor-nurse integrated systematic clinical management mode. This work mode enhanced cooperation between doctors and nurses, formed the clinical path for nursing workflows and contingency plans, and strengthened specialized education and training for nurses. Results After the implementation of systematic clinical management, the incidence of femoral pseudoaneurysm was significantly lower than before (1.0% vs. 2.7%), and the difference was statistically significant (P<0.05). Conclusions The systematic clinical management, carrying out in the doctor-nurse integration mode, can improve the quality of nursing and reduce the incidence of femoral pseudoaneurysm. And the management model has achieved remarkable results. So it is worth to be applied in the clinical practices.

    Release date:2017-09-22 03:44 Export PDF Favorites Scan
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