【摘要】 目的 探索和提高严重大血管损伤的救治水平。 方法 对1990年1月～2004年12月收治的33例颈、腹和四肢特殊型严重大血管损伤的临床资料进行总结分析。 结果 存活31例，死亡2例，抢救成功率93.94%，平均随访6.8年，均治愈，无并发症。 结论 抢救初期要注意进行有效的心肺复苏、压迫止血和快速进行深静脉插管;颈动脉转流管在严重颈动脉损伤重建过程中有重要作用;对长距离颈动脉损伤用颈外静脉移植外环包人造血管重建，可取得最佳效果;对肝静脉及肝后下腔静脉损伤，要充分暴露，采用有效方法止血和修复，对病情极危重的凶险性出血者，血液转流泵的应用可提高成功率;对大、中血管(尤其是静脉)损伤，两端均为裤式单开口自体双血管移植，解决了无适宜口径自体移植血管和应用人造血管远期易闭塞等问题;对深静脉损伤并广泛血栓形成者，应用改进的Fogarty导管和顺行插管取栓法，可有效取栓并避免了副损伤。

    关键词 血管 损伤 救治 移植 重建

    Treatment of part specific severe vessels injury

    Qu Ming，Zhang Weiguo，Du Yingdong，et al.

    Department of Hepatobiliary and Kidney Surgery，Vascular Surgery Center，The 107th Military Center Hospital，Yantai264002.

    【Abstract】 Objective To probe and raise the treatment level of serious great vessels injury.Methods The clinical materials of33patients with neck，abdomen and limbs having specific severe vessels injury，who were treated from January1990to December2004were summarized and analyzed.Results The survival was31cases，the death was2cases，the rate of success of emergency treatment was93.94%，the average follow-up was6.8years，they were all cured，and had no complications.Conclusion To pay attention to carry out effective cardiopulmonary resus-citation ......