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Management of Arterial Pseudoaneurysms with Bleeding by Injection of Addictive Prags

目的探讨毒品注射致假性动脉瘤急性破裂大出血后的急救处理。方法回顾性分析12例毒品注射致假性动脉瘤急性破裂出血患者的临床资料。结果均行单纯清创和血管修补术，术后1例患者诉右足轻度麻木，出院2个月后消失，无跛行。其余11例患者术后至出院无明显缺血表现。结论对毒品注射所致假性动脉瘤急性破裂大出血患者行单纯清创和血管修补术，手术操作简便，术后患肢血供恢复好，且费用低，适合在广大基层医院开展。

视网膜大动脉瘤

报告视网膜大动脉瘤一例，患者为69岁女性，有高血压。可见瘤体与脉搏一致的搏动，瘤体急性失代偿出血，并在出血后萎缩。 （中华眼底病杂志，1993，9：98-99）

骶髂螺钉植入术后臀上动脉假性动脉瘤形成二例

复杂性肠系膜上动脉瘤开放手术1例报道

目的总结开放手术治疗1例复杂性肠系膜上动脉瘤（superior mesenteric artery aneurysm，SMAA）的体会。 方法报道1例罕见的复杂性肠系膜上动脉瘤（superior mesenteric artery aneurysm，SMAA）患者，分析其诊断及治疗方案。结果患者为年轻女性，主要表现为逐渐加重的腹部疼痛，腹部CT血管成像检查示肠系膜上动脉中段多发动脉瘤，最大者3.4 cm×3.3 cm，累及3条主要分支，动脉瘤局部压迫胰腺，致使胰腺向前、向外移位。综合患者临床表现、解剖条件和生存预期，最终实施开放性SMAA切除+人工血管重建术。术后患者恢复良好，无肠缺血坏死，大便隐血阴性。结论SMAA患者术前应综合考虑和评估，选择最优的治疗策略。当SMAA累及多个主要分支、腔内治疗无法保证术后效果时，开放手术仍是一种行之有效的治疗方法。

Clinical Application of Selfmade Matas Test Stand

目的:介绍一种自制的Matas试验架,探讨其临床应用效果。方法:介绍Matas试验架的制作和使用方法。并对10例颈动脉体瘤、4例巨大海绵窦动脉瘤、5例外伤性颈内动脉海绵窦瘘患者进行颈动脉压迫耐受训练。通过数字减影血管造影(DSA)和经颅多普勒(TCD)检查,了解大脑动脉及Willis环侧支循环的建立和代偿情况。结果:DSA和TCD显示大脑动脉及Willis环侧支循环的建立和代偿情况良好。19例患者均实施手术治疗和介入治疗,无一例发生并发症。结论:使用自制Matas试验架来进行颈动脉压迫训练,以其定位准确、压迫可靠、稳定性好、效果确切等优点,为成功手术提供了精确的术前评估和耐受训练。

股动脉穿刺后假性动脉瘤的超声诊断与治疗

目的评价彩色多普勒超声在股动脉穿刺后股动脉假性动脉瘤形成的诊断及治疗中的临床应用价值。 方法回顾性分析2011年1月－2013年11月10例股动脉穿刺后假性动脉瘤形成的彩色多普勒超声声像图表现，总结在超声引导下对假性动脉瘤进行压迫治疗的操作方法，并对治疗结果追踪复查。 结果10例患者超声均查见股动脉周围无回声团块或混合回声团，并在瘤体内查见涡流血流信号及破口处出现“双期双向”血流频谱。10例假性动脉瘤患者行超声引导下压迫治疗，7例1次按压成功，3例重复多次按压成功。 结论彩色多普勒超声诊断假性动脉瘤准确率高，是首选的检查方法。超声引导下压迫治疗股动脉穿刺后假性动脉瘤，是一种有效的治疗方法，可以作为首选。

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

目的 提高对创伤性假性动脉瘤并动静脉瘘的影像诊断水平。 方法 报告1例腰椎间盘手术所致的创伤性假性动脉瘤并动静脉瘘，比较分析MRA和DSA对该病的诊断价值。 结果 MRA能够明确创伤性假性动脉瘤及动静脉瘘的诊断，与DSA有良好的相关性。 结论 MRA对创伤性假性动脉瘤并动静脉瘘的确诊有重要价值，在一定程度上能够代替常规血管造影。

MDT discussion of a patient with abdominal aortic aneurysm with iliac arteriovenous fistula

ObjectiveTo summarize the diagnosis and treatment experience of one case of abdominal aortic aneurysm with iliac arteriovenous fistula.MethodsA case of abdominal aortic aneurysm with left iliac arteriovenous fistula admitted to Nanchong Central Hospital in December 2019 was retrospectively analyzed. The diagnosis and treatment of the patient and the MDT discussion results were summarized.ResultsThe clinical manifestations of this patient was refractory heart failure, and he received heart medicine treatment in Nanchong Center Hospital. The patient diagnosed as abdominal aortic aneurysm with left iliac arteriovenous fistula after computed tomography angiography (CTA), abdominal aorta lumen coated stents isolation (EVAR) during operation was performed after the MDT discussion. Postoperative imaging revealed a tumor cavity abdominal aortic aneurysm and left iliac arteriovenous fistula completely closed, then the heart failure symptoms of the patient was quickly relieved. The whole operation went smoothly, with a duration of about 120 min and intraoperative blood loss of about 100 mL. The patient was discharged from hospital on the 7th day after the operation. CTA and color doppler ultrasound were rechecked in 3 months after the operation, and the stent was found to have unobtrusional blood flow and no internal leakage, and the pseudoaneurysm of the left iliac artery disappeared.ConclusionsFor patients with refractory heart failure, if accompanied by lower limb swelling, the possibility of arteriovenous fistula of the great vessels should be taken into account, and the medical history and physical examination should be collected comprehensively, and necessary examinations should be carried out timely to avoid missed diagnosis or misdiagnosis. Meanwhile, compared with traditional surgery, EVAR is a more reliable, minimally invasive, and safe treatment for abdominal aortic aneurysm with iliac arteriovenous fistula.

主动脉夹层动脉瘤支架置入术中血钾浓度异常增高二例

参附注射液对行颅内动脉瘤夹闭术患者血清SOD,MDA,S-100β 蛋白的影响

目的:观察参附注射液对行颅内动脉瘤夹闭术患者MDA,SOD,S-100β蛋白(S-100β)的影响,以探讨其脑保护的机制。方法:行颅内动脉瘤夹闭术患者随机分为参附组(Ⅰ组)和对照组(Ⅱ组),分别于术前12 h和手术日麻醉诱导前30 min给予参附注射液 1 mL/kg和生理盐水1 mL/kg,在于气管插管后即刻T1, 夹闭动脉瘤前T2,动脉瘤夹闭后30 min T3,分别缓慢抽取颈内静脉球部血样5 mL以备检测SOD活性和MDA,S-100β的含量。 结果:参附组(Ⅰ组)MDA和S-100β含量明显低于对照组(Ⅱ组),Plt;0.05,SOD活性明显高于对照组(Ⅱ组), Plt;0.05。结论:参附注射液可提高SOD活性,降低MDA和S-100β的含量,从而对行颅内动脉瘤夹闭术患者有脑保护作用。