外傷性膝窩動脈損傷の3例 THREE CASES OF TRAUMATIC POPLITEAL ARTERY INJURY
交通事故による外傷性膝窩動脈損傷の3例を経験した. 1例は脛骨骨折, 2例は膝靱帯損傷を合併し, 3例ともに自家静脈で再建,救肢し得た.減張切開は2例に施行, 1例は術後MNMS (myonephropathic metabolic syndrome)を併発したが,血液濾過にて救命し得た.本疾患は,他の四肢動脈損傷に比べ,肢切断率が高いため早期診断,早期治療が重要で,積極的な筋膜切開と同時に血行再建後もMNMSの発生に十分注意を払い,予兆がみられれば,ただちに血液濾過などの対策を講じる必要がある.
We have experienced three cases of traumatic popliteal artery injury in traffic accident. Of these three cases, one case was associated with a fracture of the tibia and two cases with an injury of the patellar ligament. All three limbs in them were successfully salvaged by reconstruction using autologous veins. Tension incision was conducted in two cases. Of the two cases one case was associated with postoperative myonephropathic metabolic syndrome (MNMS), but the life of the patient was saved by hemofiltration.<br> As the disease often demands amputation in a high frequency compared with other injuries of the limb arteries, early diagnosis and prompt treatment are critical. We have to perform fascial incision aggressively as well as to be alert for the occurrence of MNMS even after revascularization. If any signs are seen, immediate therapeutic strategies including hemofiltration should be employed.
- 日本臨床外科医学会雑誌 = The journal of the Japanese Practical Surgeon Society
日本臨床外科医学会雑誌 = The journal of the Japanese Practical Surgeon Society 58(8), 1897-1901, 1997-08-25