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[1]趙彬,吳蓓茸,夏煒,等.下肢大動(dòng)脈損傷術(shù)后血管危象的監(jiān)測(cè)及危險(xiǎn)因素分析[J].中醫(yī)正骨,2011,23(11):14-16.
　ZHAO Bin*,WU Bei-rong,XIA Wei,et al.Monitoring of vascular crisis after reconstruction of lower extremity artery injury and analysis of its risk factors[J].The Journal of Traditional Chinese Orthopedics and Traumatology,2011,23(11):14-16.
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下肢大動(dòng)脈損傷術(shù)后血管危象的監(jiān)測(cè)及危險(xiǎn)因素分析()
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《中醫(yī)正骨》[ISSN:1001-6015/CN:41-1162/R]

卷:
第23卷
期數(shù):
2011年11期
頁(yè)碼:
14-16
欄目:
臨床研究
出版日期:
2011-11-30

文章信息/Info

Title:
Monitoring of vascular crisis after reconstruction of lower extremity artery injury and analysis of its risk factors
作者:
趙彬; 吳蓓茸; 夏煒; 趙佳麗
溫州醫(yī)學(xué)院附屬第二醫(yī)院,浙江 溫州 325027
Author(s):
ZHAO Bin*; WU Bei-rong;  XIA Wei; et al.*
The second affiliated hospital of Wenzhou Medical College,Wenzhou 325027,Zhejiang,China
關(guān)鍵詞:
下肢大動(dòng)脈損傷 血管危象監(jiān)測(cè) 危險(xiǎn)因素
Keywords:
Lower extremity;  Artery injury;  Vascular crisis;  Monitoring;  Risk factors
摘要:
目的:探討下肢大動(dòng)脈損傷術(shù)后血管危象的監(jiān)測(cè)措施,分析血管危象發(fā)生的危險(xiǎn)因素。方法:回顧性總結(jié)我院自2004年1月至2010年1月收治的114例下肢大動(dòng)脈損傷病例中發(fā)生血管危象11例患者的臨床監(jiān)測(cè)及護(hù)理措施,對(duì)下肢動(dòng)脈術(shù)后發(fā)生血管危象的主要可能危象因素進(jìn)行單因素與多因素 Logistic 回歸分析。結(jié)果:11例血管危象皆發(fā)生于術(shù)后72 h內(nèi),患肢皮溫減低是血管危象發(fā)生后的早期征象,與健側(cè)溫差平均為(3.6±0.41)℃(3.1～4.5 ℃); 肢端切口放血無(wú)血、緩慢或色澤暗紫是血管危象發(fā)生的直接客觀指標(biāo); 單因素分析及多因素 Logistic 回歸分析結(jié)果顯示年齡與損傷機(jī)制為血管危象發(fā)生的主要危險(xiǎn)因素,性別與修復(fù)方式對(duì)血管危象的發(fā)生無(wú)顯著影響。結(jié)論:術(shù)后72 h內(nèi)密切觀察肢端血運(yùn),注意皮溫的監(jiān)測(cè),尤其關(guān)注與健側(cè)皮溫的對(duì)比,皮溫減低是較直觀準(zhǔn)確的簡(jiǎn)易觀察指標(biāo),肢端放血法是簡(jiǎn)單客觀的監(jiān)測(cè)方法; 高齡與血管的廣泛損傷是血管危象的主要危險(xiǎn)因素。
Abstract:
Objective:To explore the monitoring measures of vascular crisis after reconstruction of lower extremity artery injury and analyze its risk factors.Methods:The clinical data of 114 cases of lower extremity artery injury from Jan 2004 to Jan 2010,of which there were 11 cases sustained vascular crisis after arterial reconstruction,were investigated retrospectively.The monitoring measures performed were summarized and the possible risk factors of vascular crisis were analyzed using Chi-square and Logistic regression analysis.Results:All the 11 cases of vascular crisis occurred within 72h postoperatively.The continuous skin temperature dropping was the early sign of vascular crisis with 3.6±0.41(3.1～4.5)℃ lower than that of the normal side averagely and bleeding slowly in dark color or even no bleeding using blood-letting technique was the solid evidence of vascular crisis.Chi-square and Logistic regression analysis showed that age and causes of injury were the major predictors of vascular crisis after reconstruction of lower extremity artery injury,while no evidence of the sex and repair mode was found to contribute to the vascular crisis.Conclusion:Obvious skin temperature dropping compared with the unaffected site within 72h postoperatively is the simple and precise method for monitoring the vascular crisis,together with the blood-letting technique.Advanced age and extensive blunt trauma are the main risk factors of vascular crisis after reconstruction of lower extremity artery injury.

參考文獻(xiàn)/References:

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更新日期/Last Update: 1900-01-01