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題名 | Surgical Repair of Infected Pseudoaneurysm Originating from Native Arteriovenous Fistula for Hemodialysis: Report of a Case=手術治療自體洗腎瘻管形成之感染性偽動脈瘤:病例報告 |
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作者 | 陳勁辰; 莊義成; 李國楨; 張忠毅; 魏崢; 蘇上豪; Chen, Robert J.; Chuang, Yi-cheng; Lee, Kuo-chen; Chang, Chung-yi; Wei, Jeng; Sue, Sung-how; |
期刊 | 臺灣外科醫學會雜誌 |
出版日期 | 20080300、20080400 |
卷期 | 41:2 2008.03-04[民97.03-04] |
頁次 | 頁56-60 |
分類號 | 416.263 |
語文 | eng |
關鍵詞 | 感染性偽動脈瘤; 血管通路; 次發性感染; Infected pseudoaneurysm; Vascular access; Autogenous fistula; |
中文摘要 | 由自體血管通路發生之次發性感染,就發生率而言並不常見,但是病程可能會快速惡化。我們報告一個病案,病人爲27歲女性,來院病徵表現爲寒顫併發燒,左手臂有一顆在三天內快速增大之脈動性腫塊。我們便高度懷疑,這是源自血管通路之感染性偽動脈瘤。她的情況快速惡化,轉至加護病房繼續接受治療,我們也進行了急診手術。血管縫合結紮和抗生素治療並不足夠,因爲她的患部組織脆弱及充滿膿液。我們做了清創,感染部位瘻管之節段切除,並使用腿部大隱靜脈對左臂動脈之繞道手術。治療成功且無後遺症。此篇報告之目的在於強調科際問及時照會和正確外科重建手術之重要性,腎臟科醫師和心臟血管外科醫師問之密切合作,對感染性偽動脈瘤之病患才有最大益處。 |
英文摘要 | Infection secondary to an autogenous vascular access, or an arteriovenous fistula (AVF), is low in terms of incidence, but its course may be fulminant. We report a case of a 27-year-old female, presenting with chills, fever, and a rapidly-progressive pulsatile mass on her left elbow within three days. Infected pseudoaneurysm from hemodialysis vascular access was highly suspected. Her condition went downhill at the intensive care unit and emergent surgery was carried out. Suture ligation and antibiotics were not adequate due to her friable and pus-flooded tissue. We performed debridement, segmental resection of the infected fistula, and bypass surgery for the left brachial artery with a saphenous vein graft. The postoperative course was smooth. The purpose of this article is to show the importance of timely consultation and proper surgical reconstruction by cardiovascular surgeons for the maximum benefits of the patients with infected pseudoaneurysms. |
本系統之摘要資訊系依該期刊論文摘要之資訊為主。