【摘要】 目的 探讨腰椎结核病灶清除术中出现大血管副损伤的原因，处理以及对此并发症的预防措施。方法 采用腰椎结核病灶清除术中出现较大血管损伤49例的临床资料，对其损伤部位、方式原因及对此并发症的预防和处理措施进行分析。结果 分别对损伤的部位采取单纯缝合、缝合辅加明胶海绵覆盖及纱布压塞、血管钳夹留置与纱布压塞，进行血管移植术等措施，除1例因失血性休克死亡外，余均脱险成功。结论 因为下腰椎手术解剖复杂。所以切口宜长勿短、暴露充分。节段多，成角重的可在腰部加放薄枕，腹膜囊推剥充分，超越中线，下腔静脉分叉部周围血管清晰，掌握血管分叉部以下手术入路的注意要点。术者应技术熟练，动作准确，操作得当，这样可以大大减少或避免大血管损伤的发生。

    关键词 腰椎结核 血管损伤 处理与预防 术中并发症

    Causes Treatment And Prevention of Majar Vascular Injuries During Focal Debri-dment of Lumbar Tuberculosis.

    Liu Huaming

    Department of Orthopedics，Provincial Hospital of Tuberculosis，JiLin Jiutai130500.

    【Abstract】 Objective To oberve the possible causes injuries during focal debridement of the Lumbar tuberˉculosis.Methods 49Patients with major Vascular mjuries of focal debrid-ment of the Lumber tuberculosis were reˉvieved.The reginons mannens and causes of injuries，the prevention and tretment of this complication were studied.Results 49Patients were used to mjury region separately treated alone ......