目的探討復(fù)雜的創(chuàng)傷性動脈瘤（TAA）和動靜脈瘺（TAVF）的手術(shù)方法和療效。方法對我院1963年6月至2000年12月經(jīng)手術(shù)治療的TAA和TAVF 121例進行回顧性分析。結(jié)果TAA ７１例含９１個動脈瘤，TAVF ５０例含５４個動靜脈瘺。手術(shù)方式包括瘤體切除和端端吻合或血管移植或上下結(jié)扎，瘤體上下結(jié)扎加血管旁路移植，直接修補或補片。瘺管切除加四頭結(jié)扎或動靜脈移植或動靜脈修補，介入栓塞治療。死亡１例。TAA、TAVF隨訪率分別為６５.７%和６０.0%。遠期效果好。結(jié)論不同部位復(fù)雜的TAA和TAVF應(yīng)根據(jù)其不同分型采用不同的手術(shù)方式，對選擇性病例可考慮做介入治療。
引用本文： 喬正榮,時德,戴毅,蔣鷗,王志剛. 創(chuàng)傷性動脈瘤和動靜脈瘺的術(shù)式選擇. 中國普外基礎(chǔ)與臨床雜志, 2004, 11(4): 314-316. doi: 復(fù)制
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- 1. 時德， 張依仁， 劉象和， 等. 創(chuàng)傷性動脈瘤和動靜脈瘺 [Ｊ]. 中華創(chuàng)傷雜志， 1996； 12（4）∶215.
- 2. Coldwell DM, Novak Z, Ryu RK, et al. Treatment of posttraumatic internal carotid arterial pseudoaneurysms with endovascular stents [Ｊ]. J Trauma, 2000; 48(3)∶470.
- 3. Luo CB, Lirng JF, Teng MM, et al. Endovascular embolization of arteriovenous fistulas of the external carotid artery [Ｊ]. Zhonghua Yi Xue Za Zhi (Taipei), 1998; 61(5)∶260.
- 4. Kirchgatterer A, Baldinger C, Lenglinger F, et al. Portal hypertension due to traumatic hepatic arterioportal fistula: report of successful embolization [Ｊ]. Eur J Gastroenterol Hepatol, 1998; 10(12)∶1057.
- 5. Balci NC, Semelka RC, Sandhu JS. Intrahepatic arterioportal fistula: gadoliniumenhanced 3D magnetic resonance angiography findings and angiographic embolization with steel coils [Ｊ]. Magn Reson Imaging, 1999; 17(3)∶475.
- 6. Davis KA, Fabian TC, Croce MA, et al. Improved success in nonoperative management of blunt splenic injuries: embolization of splenic artery pseudoaneurysms [Ｊ]. J Trauma, 1998; 44(6)∶1008.
- 7. Maloo MK, Burrows PE, Shamberger RC. Traumatic splenic arteriovenous fistula: splenic conservation by embolization [Ｊ]. J Trauma, 1999; 47(1)∶173.
- 8. Wang KT, Hou CJ, Hsieh JJ, et al. Late development of renal arteriovenous fistula following gunshot traumaa case report [Ｊ]. Angiology, 1998; 49(5)∶415.
- 9. Reber PU, Baer HU, Patel AG, et al. Superselective microcoil embolization: treatment of choice in highrisk patients with extrahepatic pseudoaneurysms of the hepatic arteries [Ｊ]. J Am Coll Surg, 1998; 186(3)∶325.
- 10. Sharma S, Bhargava B, Mahapatra M, et al. Pseudoaneurysm of the superficial femoral artery following accidental trauma: result of treatment by percutaneous stentgraft placement [Ｊ]. Eur Radiol, 1999; 9(3)∶422.
- 11. Thalhammer C, Kirchherr AS, Uhlich F, et al. Postcatheterization pseudoaneurysms and arteriovenous fistulas: repair with percutaneous implantation of endovascular covered stents [Ｊ]. Radiology, 2000; 214(1)∶127.