Lee James T, Bongard Frederic S
Division of Vascular Surgery, Harbor-UCLA Medical Center, Torrance, California 90509, USA.
Surg Clin North Am. 2002 Feb;82(1):21-48, xix. doi: 10.1016/S0039-6109(03)00139-7.
Trauma to the iliac vasculature continues to pose a significant challenge to management. In several large series, mortality for penetrating injuries is reported as approaching 40%. Uncontrollable hemorrhage originating from an anatomically inaccessible source and multiple associated injuries often contribute to this high mortality rate. This article discusses the current existing management strategies and the controversial role of PTFE in vascular reconstruction within a contaminated field. Concomitant injuries to the enteric viscera and genitourinary system are also addressed. Postoperative management including anticoagulation and the complications of liberal fasciotomy are mentioned. The evolving role of endovascular therapy as an adjunctive modality in the armamentarium of the trauma surgeon is also presented briefly.
髂血管创伤的处理仍然是一项重大挑战。在几个大型系列研究中，穿透伤的死亡率据报道接近40%。源于解剖位置难以到达的部位的难以控制的出血以及多种合并伤常常导致如此高的死亡率。本文讨论了目前现有的处理策略以及聚四氟乙烯（PTFE）在污染区域血管重建中存在争议的作用。还讨论了肠道脏器和泌尿生殖系统的合并伤。提及了术后处理，包括抗凝以及广泛筋膜切开术的并发症。还简要介绍了血管内治疗作为创伤外科医生手段中辅助方式的不断演变的作用。
