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The Character and Surgery of Pseudocyst Due to Acute Pancreatitis （Report of 115 Cases）

ObjectiveTo determine the characters of symptomatic pancreatic pseudocyst due to acute pancreatitis and effects of surgical treatment with two kinds of procedure （internal drainage or external drainage）. MethodsOne hundred and fifteen cases hospitalized during recent ten years were retrospectively analyzed.ResultsWe found that necrotic tissue existed in the pseudocyst in most cases and infection might occur in these pseudocyst. Although effect of two kinds of surgery was similar, the clinical course was different. The complications after surgery were fewer in patients underwent internal drainage than that with procedure of external drainage, and average hospital day was 7d in cases with internal drainage and 11d in cases with external one respectively. Surgery of internal drainage used in treatment was not only successful in noninfectious and single pseudocyst, but in infectious or multiple seudocyst.ConclusionInternal drainage should be used in most cases and considered as the first selection in surgery of pseudocyst due to acute pancreatitis.

骶髂螺釘植入術后臀上動脈假性動脈瘤形成二例

外傷性主動脈弓部破裂巨大假性動脈瘤形成腔內修復術一例

Clinical Analysis of Internal Drainage Treatment for 20 Patients with Pancreatic Pseudocysts

目的 探討胰腺假性囊腫行內引流治療的臨床效果。方法 對我院2001年1月至2008年12月期間收治的20例胰腺假性囊腫行內引流治療的臨床資料進行回顧性分析。結果 本組20例中行囊腫與胃吻合7例,囊腫與空腸Roux-en-Y吻合13例。14例獲得3個月~6年（平均32個月）隨訪，均獲一次性治愈，無近、遠期并發癥發生。結論 根據囊腫形成的大小和時間選擇恰當的內引流治療方式，能有效治愈胰腺假性囊腫。

VASCULAR RECONSTRUCTION OF INFECTED PSEUDOANEURYSM IN 17 DRUG ADDICTS

Objective To evaluate surgical treatment of infected pseudoaneurysm (PA) caused by injection of addictive drugs. Methods The clinical data of 17cases of infected PA caused by drug injection were reviewed retrospectively. Ofthem, 1 case was female, and the other 16 cases were male, aging 24-38 years. The locations were brachial artery in 1 case and femoral artery in 16 cases. Fourteen cases were treated by artificial blood vessel transplantation after resection of the aneurysm and radical debridement, 1 case by amputation for serious infection, and 2 cases by non-operation for different reasons. Results Among 14 cases treated by prosthetic grafts, 13 cases achieved satisfactory results, no blood drawback of lower extremity occurred after operation; 1 case had to be amputated for serious infection. After 3 months of operation, the color Doppler examination showed that the 9 artificial vessel grafts were patent and the pulse of arteria dorsal pedis was good. Conclusion Though artificial vessel grafting has high risk in the vicinity of infected PA, it is still an effective procedure for revascularization in condition that there is no suitable autogenous conduit available for auto transplantation. Sufficient drainage, anti-infection and anti-coagulation therapy should be the key factors after the operation.

股骨粗隆間骨折內固定術后并發股深動脈假性動脈瘤一例

目的總結1例股骨粗隆間骨折內固定術后并發股深動脈假性動脈瘤診治體會。 方法2011年10月收治1例摔傷致右側股骨粗隆間骨折的女性患者，年齡78歲。入院后采用股骨近端防旋髓內釘（proximal femoral nail antirotation，PFNA）行骨折復位內固定術。術后第9天出現患側大腿疼痛并逐漸加重，血紅蛋白降低。第13天B超檢查示右大腿前側包塊。急診行右下肢超選擇性血管造影術，示股深動脈第2穿支遠端假性動脈瘤形成。用彈簧圈行第2穿支動脈栓塞術。 結果栓塞術后患側大腿疼痛明顯減輕，腫脹逐漸消退，順利出院。患者獲隨訪2年，右股骨粗隆間骨折完全愈合，患側髖關節功能Harris評分為優。 結論股骨粗隆間骨折內固定術后如出現不明原因患側大腿疼痛、腫脹、血紅蛋白進行性下降等，應警惕假性動脈瘤的發生，行選擇性血管造影術明確并選擇相應治療方法。

股動脈穿刺后假性動脈瘤的超聲診斷與治療

目的評價彩色多普勒超聲在股動脈穿刺后股動脈假性動脈瘤形成的診斷及治療中的臨床應用價值。 方法回顧性分析2011年1月－2013年11月10例股動脈穿刺后假性動脈瘤形成的彩色多普勒超聲聲像圖表現，總結在超聲引導下對假性動脈瘤進行壓迫治療的操作方法，并對治療結果追蹤復查。 結果10例患者超聲均查見股動脈周圍無回聲團塊或混合回聲團，并在瘤體內查見渦流血流信號及破口處出現“雙期雙向”血流頻譜。10例假性動脈瘤患者行超聲引導下壓迫治療，7例1次按壓成功，3例重復多次按壓成功。 結論彩色多普勒超聲診斷假性動脈瘤準確率高，是首選的檢查方法。超聲引導下壓迫治療股動脈穿刺后假性動脈瘤，是一種有效的治療方法，可以作為首選。

Application of MRA and DSA on Diagnosis of Traumatic Pseudoaneurysm and Arteriovenous Fistula (Report of 1 Case)

目的 提高對創傷性假性動脈瘤并動靜脈瘺的影像診斷水平。 方法 報告1例腰椎間盤手術所致的創傷性假性動脈瘤并動靜脈瘺，比較分析MRA和DSA對該病的診斷價值。 結果 MRA能夠明確創傷性假性動脈瘤及動靜脈瘺的診斷，與DSA有良好的相關性。 結論 MRA對創傷性假性動脈瘤并動靜脈瘺的確診有重要價值，在一定程度上能夠代替常規血管造影。

Experience of Infected Pseudoaneurysms of Femoral Artery Caused by Drug Injection

目的探討毒品注射所致感染性假性動脈瘤的特點及治療方法與臨床療效。方法回顧性分析我院血管外科2009年1月至2010年6月期間收治的13例感染性假性動脈瘤吸毒患者的臨床資料，采用切除瘤體及周圍炎性組織、瘤腔清創及動脈結扎或人工血管置換術，觀察移植效果及并發癥發生情況。結果13例手術均獲成功，無一例發生肢體壞死； 傷口一期愈合5例，二期愈合8例； 7例發生程度不等的淋巴瘺。隨訪2～12個月（平均7個月），其中1例術后2個月瘤腔下端感染形成膿腫伴出血，行切開引流痊愈； 2例術后4個月人造血管感染行人造血管摘除，切口換藥痊愈； 有2例左肘部假性肱動脈瘤直接行血管結扎，未用人工血管移植； 余8例復查B超顯示移植血管通暢，無血栓形成。結論徹底清創、血管移植、控制感染是治療感染性假性動脈瘤的有效方法。

覆膜支架治療難治性股動脈假性動脈瘤的探討

目的探討覆膜支架置入治療難治性股動脈假性動脈瘤的有效性及其安全性。方法2012 年 8 月至 2017 年 8 月期間，河西學院附屬張掖人民醫院血管外科共收治了 26 例難治性股動脈假性動脈瘤患者，其中屬外傷性股動脈假性動脈瘤 20 例，醫源性股動脈假性動脈瘤 6 例；26 例中有 8 例合并股動-靜脈瘺。26 例患者術前全部經彩超檢查得以確診，并在彩超引導下進行常規壓迫或瘤腔內注射血凝酶治療，但均未獲成功，26 例患者最終改行股動脈覆膜支架置入術治療，其中 4 例同期行血腫清除術，2 例行假性動脈瘤腔內穿刺引流術。結果全部患者一期置入覆膜支架均獲成功，股動脈假性動脈瘤及動-靜脈瘺均治愈，6 例患者股深動脈封閉，無手術死亡及嚴重并發癥發生。術后 6 個月及 12 個月進行隨訪，26 例患者均無瘤體復發及支架移位、斷裂、栓塞和內瘺發生。結論覆膜支架置入治療難治性股動脈假性動脈瘤是安全、有效、微創的方法，其短期效果滿意，遠期療效有待進一步觀察。