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对308例四肢主干血管急性损伤进行回顾分析.方法 本组共308例,其中开放性损伤181例,闭合性损伤127例.男299例,女9例.年龄最大62岁,最小6岁,平均24.5岁.对该种损伤患者尽早施行手术清创、探查.具体修复方法为:(1)单纯修补缝合受损的血管.(2)血管端端吻合术.(3)血管移植.结果3例因吻合口血栓形成发现较晚而截肢.1例因肢体血循环重建时间较长,术后出现骨筋膜室综合征和肾功能衰竭而截肢.1例术后发生严重感染,高度怀疑气性坏疽而截肢.余303例肢体全部存活.结论(1)诊断明确后或高度怀疑有血管损伤者,应尽早行手术探查.(2)血管端端吻合、血管移植是首选的手术方法.(3)肢体血循环重建的时限可根据伤情适当延长.(4)血管不完全断裂较完全断裂者并发休克率明显增多.“,”Objective To retrospectively study the results of 308 patients with acute large artery injuries. Methods Three hundred and eight patients with acute large artery injuries were reviewed. The managements were direct suture, end to end anastomosis, and reconstruction by saphenous vein graft. Results Amputation had been done in 5 patients. Three of them were due to late thrombosis in anastomostic stoma; 1 had severe infection highly suspicious of gas gangrene; and 1 had osteofascial compartment syndrome and renal failure. The other 303 patients all had their limbs survived and got good function. Conclusion The surgical exploration should be done as soon as possible when diagnosis of injuries of large arteries is definite or highly suspected. End-to-end anastomosis and venous graft are the procedure of choice. Revascularization of a damaged artery should not be limited by time. Shock more often companies with partial rupture than complete one.