Avrahami R, Haddad M, Watemberg B, Stelman E, Koren A, Dahn J, Zelikovski A
Dept. of Vascular Surgery, Rabin Medical Center (Beilinson Campus), Petah Tikva.
Harefuah. 1998 Jun 1;134(11):855-8, 919.
6 cases of popliteal vascular trauma are presented, 3 due to posterior dislocation of the knee and 3 due to crush injury. The patients were referred from another hospital and some had undergone unnecessary angiography when ischemia was present, leading to delay in surgery. All patients presented with distal ischemia and underwent reconstructive surgery; 2 subsequently underwent below-knee amputation because of irreversible ischemia and sepsis. Urgent operation for popliteal vascular trauma is necessary whenever there is ischemia and intraoperative angiography may be necessary. There should be reconstruction of the artery and vein when there is concomitant venous damage, and fasciotomy and debridement are important. The harmful potential of occult popliteal vascular injuries and their ostensible mild presentation present a challenge for the emergency room surgeon.
本文报告6例腘血管创伤病例，其中3例因膝关节后脱位所致，3例因挤压伤所致。患者均由其他医院转诊而来，部分患者在出现缺血时接受了不必要的血管造影检查，导致手术延误。所有患者均表现为远端缺血，并接受了重建手术；2例患者随后因不可逆性缺血和脓毒症接受了膝下截肢手术。只要出现缺血，就有必要对腘血管创伤进行紧急手术，术中可能需要进行血管造影检查。当伴有静脉损伤时，应重建动静脉，筋膜切开术和清创术很重要。隐匿性腘血管损伤的潜在危害及其表面上的轻微表现给急诊外科医生带来了挑战。
