[1]郑 波,李兆南,袁 罡,等.股动脉穿刺并发股神经损伤相关因素分析 [J].介入放射学杂志,2018,27(10):963-965.
 ZHENG Bo,LI Zhaonan,YUAN Gang,et al.Femoral nerve injuries caused by femoral artery puncturing: analysis of related factors[J].journal interventional radiology,2018,27(10):963-965.
点击复制

股动脉穿刺并发股神经损伤相关因素分析 
()

PDF下载中关闭

分享到:

《介入放射学杂志》[ISSN:1008-794X/CN:31-1796/R]

卷:
27
期数:
2018年10期
页码:
963-965
栏目:
临床研究
出版日期:
2018-10-25

文章信息/Info

Title:
Femoral nerve injuries caused by femoral artery puncturing: analysis of related factors
作者:
郑 波 李兆南 袁 罡 徐燕能 胡 伟 张向琼 马小燕 斯光晏
Author(s):
ZHENG Bo LI Zhaonan YUAN Gang XU Yanneng HU Wei ZHANG Xiangqiong MA Xiaoyan SI Guangyan.
Department of Interventional Radiology, Affiliated Hospital of Traditional Chinese Medicine, Southwest Medical University, Luzhou, Sichuan Province 646000, China
关键词:
【关键词】 股动脉穿刺 股神经 股神经损伤
文献标志码:
A
摘要:
【摘要】 目的 分析股动脉穿刺并发股神经损伤的原因,以期提高临床诊治水平。方法 回顾性分析2012年1月至2016年12月股动脉穿刺置管4 673例,其中6例根据临床表现及神经肌电图检查确诊为股神经损伤(2例直接穿刺伤,1例穿刺点血肿压迫继发伤,3例止血带压迫伤)。4例接受神经松解、神经阻滞治疗结合药物治疗(扩血管改善微循环及维生素B1营养神经等);2例接受单纯药物治疗。结合临床表现和文献分析股神经损伤原因。结果 术后平均随访3个月(1~6个月),所有患者股四头肌肌力由治疗前3~4级恢复至4~5级,伸膝功能及步态正常;4例感觉功能完全恢复,1例随访3个月后仍有大腿下2/3前下及小腿内侧感觉减退,1例止血带压迫损伤患者肌力恢复正常,但随访4个月后仍有感觉障碍。结论 股神经损伤是一种临床少见的经皮穿刺置管并发症,医源性损伤不容忽视,患肢肌力下降、大腿感觉异常应引起重视,早期诊断及及时、适当治疗是预后良好的关键。

参考文献/References:

[1] Kent KC, McArdle CR, Kennedy B, et al. A prospective study of the clinical outcome of femoral pseudoaneurysms and arteriovenous fistulas induced by arterial puncture[J]. J Vasc Surg, 1993, 17: 125- 133.
[2] Rasulic L, Savic A, Vitosevic F, et al. Iatrogenic peripheral nerve injuries. Surgical treatment and outcome: 10 years’ experience[J]. World Neurosurg, 2017, 103: 841- 851.
[3] 祝慧鹏, 周艺琳, 郭劝民, 等. 腹主动脉瘤腔内隔绝术后神经缺血性损伤[J]. 浙江临床医学, 2007, 12: 34- 35.
[4] 王金林, 盛诗儒, 金 涛. Seldinger改良法与Seldinger法动脉穿刺插管技术对比分析[J]. 介入放射学杂志, 1998, 7: 247- 248.
[5] El- Ghanem M, Malik AA, Azzam A, et al. Occurrence of femoral nerve injury among patients undergoing transfemoral percutaneous catheterization procedures in the United States[J]. J Vasc Interv Neurol, 2017, 9: 54- 58.
[6] 曹莉明, 王 杰, 施海彬, 等. 股动脉穿刺定位方法的优化研究[J]. 介入放射学杂志, 2013, 22: 409- 412.
[7] Gabriel M, Pawlaczyk K, Waliszewski K, et al. Location of femoral artery puncture site and the risk of postcatheterization pseudoaneurysm formation[J]. Int J Cardiol, 2007, 120: 167- 171.
[8] Saraf SK, Singh OP, Singh VP, et al. Peripheral nerve complications in hemophilia[J]. J Assoc Physicians India, 2003, 51: 167- 169.
[9] Ong HS. Compressive femoral neuropathy: a rare complication of anticoagulation[J]. Singapore Med J, 2007, 48: e94- e95.
[10] Mwipatayi BP, Daneshmand A, Bangash HK, et al. Delayed iliacus compartment syndrome following femoral artery puncture: case report and literature review[J]. J Surg Case Rep, 2016, pii: rjw102.
[11] Gogus A, Ozturk C, Sirvanci M, et al. Femoral nerve palsy due to iliacus hematoma occurred after primary total hip arthroplasty[J]. Arch Orthop Trauma Surg, 2008, 128: 657- 660.
[12] 周玉杰, 霍 勇, 葛均波, 等. 心血管介入治疗并发症病例与图谱[M]. 天津: 天津出版传媒集团, 2013: 9- 14.
[13] Pirouzmand F, Midha R. Subacute femoral compressive neuropathy from iliacus compartment hematoma[J]. Can J Neurol Sci, 2001, 28: 155- 158.
[14] Kong WK, Cho KT, Lee HJ, et al. Femoral neuropathy due to lliacus muscle hematoma in a patient on warfarin therapy[J]. J Korean Neurosurg Soc, 2012, 51: 51- 53.

相似文献/References:

[1]莫 伟,向 华,阳秀春,等.股动脉穿刺介入术后制动时间的循证证据研究[J].介入放射学杂志,2019,28(01):85.
 MO Wei,XIANG Hua,YANG Xiuchun,et al.Evidence- based study on optimal bed rest time after femoral artery puncture and interventional procedures[J].journal interventional radiology,2019,28(10):85.
[2]李玉莲,莫 伟,刘欢欢,等.Meta分析经股动脉穿刺介入术后穿刺部位出血的危险因素[J].介入放射学杂志,2024,33(03):314.
 LI Yulian,MO Wei,LIU Huanhuan,et al.The risk factors for puncture site bleeding after transfemoral artery puncture intervention: a meta-analysis[J].journal interventional radiology,2024,33(10):314.

备注/Memo

备注/Memo:
(收稿日期:2017-10-16)
(本文编辑:边 佶)
更新日期/Last Update: 2018-10-15