目的 研究腘动脉损伤及早诊断与合理治疗方法的选择. 方法 选取25例诊治和随访资料完整的腘动脉损伤患者,其中锐性损伤6例(24%),钝性损伤19例(76%) ;合并开放性骨折10例(40%),闭合性骨折及膝关节脱位13例(52%),静脉损伤3例(12%),神经损伤5例(20%);分析延迟诊断原因,比较腘动脉损伤原因、类型、合并损伤及发病到救治时间与预后的关系. 结果 手术修复腘动脉同时取栓20例(80%),血管腔内治疗5 例(20%);血供完全恢复16例(64%),改善3例(12%),截肢6例(24%). 发病6~8 h内救治者截肢率明显低于8 h以上者(P8 h、合并膝关节脱位及周围损伤是致残的主要原因. 及早诊断、以手术修复同时取栓为主要治疗手段,血管腔内治疗是有效的补充治疗手段.%Objective To investigate the early diagnosis and rational treatment of popliteal artery injury so as to im-prove the lower limb salvage rate. Methods The clinical and follow-up data integrity of 25 patients with popliteal artery injury was systematically studied. In these patients , 19(76%)cases were blunt injury and 6(24%) cases were penetrating injury. The combined injury included open fracture in 10 cases(40%) ,the knee joint dislocation with closed fracture of lower limb in 13(52%),nerve injury in 5(20%) and venous injury in 3(12%),respective-ly. The cause of delayed diagnosis and relationship between prognosis and type of injury, complications, the dura-tion from injured to treatment time were analyzed. Results 20 cases were operated to repair the popliteal artery. Endovascular treatment in 5 cases, the blood supply completely recovered (64%) in 16 cases, improved in 3 cases (12%) , 6 cases (24%) amputed, respectively. Rate of amputation within 6~8 hours was significantly lower than that of the more than 8 hours from the injuried to treatment time ( P<0. 05 ) . Amputation rate in blunt injury and combined injury was significantly higher than that of sharp injury ( P<0. 05 ) . Conclusion The duration from inju-ry to surgery more than 8 h, combined with knee joint dislocation and wound around knee is a major cause of mor-bidity. Operation with arterial thrombectomy is the main treatment, while endovascular treatment is a complementa-ry treatment to save the lower limb.
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