PHẪU THUẬT ĐIỀU TRỊ CHẤN THƯƠNG ĐỘNG MẠCH KHOEO TẠI BỆNH VIỆN HỮU NGHỊ VIỆT ĐỨC GIAI ĐOẠN 2017 – 2019

Abstract

Objectives: Evaluate clinical and paraclinical characteristics and early results of surgery for polipteal artery injury at Viet Duc Hospital in the period of 2017 – 2019. Methods: The study retrospectively described patients with polipteal artery injury, with full medical records, undergoing revascularization surgery from 1/2017 to 12/2019 at Viet Duc Hospital. Results: The total number of patients in the study was 147. The median age was 32.5±12.5.  100% have signs of weak or lost peripheral pulse. Bone fractures, dislocation of the knee area accounted for 91.8%.  Doppler of the lower extremity was abnormal in all cases, while MSCT scan was indicated for only 14 patients. Arterial constution was the most common lesion (81.6%); vascular revascularization surgery was mainly reversible intravenous grafting (57.1%). The fractured bones and dislocated knee joint were fixed before restoring vascular circulation. A fasciotomy procedure was perfomed for assessing the severity of the limb and reducing limb ischemia during the waiting period for surgery. Infection and muscle necrosis were the most common complications after surgery (42.2%).  7 patients (4.8%) had amputations, two dues to muscle necrosis, infection, and embolism. Conclusion: Blunt polipteal artery injury needs to be diagnosed and treated promptly. Fixation of the bones and knee joint, early revascularization surgery with autologous veins combined with fasciotomy procedure when indicated are key factors in reducing amputation rates and other severe complications.