Ockert S, Winkler M, Richter A, Palma P, Post S
Chirurgische Klinik, Universitätsklinikum Mannheim gGmbH, Germany.
Zentralbl Chir. 2002 Aug;127(8):689-93. doi: 10.1055/s-2002-33575.
The aim of the present examination was to analyse extremity trauma with additional vascular injuries. Between 1973-2000 78 patients with traumatic peripheral vascular injuries have been treated at the Surgical Department of the University Hospital of Mannheim. In addition to clinical examination Doppler-Duplex ultrasonography (cw-Doppler) was routinely performed. In selected cases either conventional or magnetic resonance angiography completed the diagnostic procedure. Vascular injuries to the upper extremities were found in 46.2 % (n = 36) whereas 53.8 % (n = 42) of the patients suffered from trauma of the lower extremities. The popliteal artery was affected in 28.2 % followed by the brachial artery with 23.1 %. 52.6 % of the patients had interposition of autologous vein for reconstruction. Only 7.7 % of the cases needed interposition of alloplastic material. In general the injured extremity was immobilised by external fixation, followed by secondary vascular reconstruction. An efficient trauma management reduced amputation rate as low as 2.6 %.
本次检查的目的是分析伴有附加血管损伤的肢体创伤情况。1973年至2000年间，曼海姆大学医院外科共治疗了78例创伤性外周血管损伤患者。除临床检查外，常规进行多普勒双功超声检查（连续波多普勒）。在特定病例中，常规血管造影或磁共振血管造影完善了诊断程序。上肢血管损伤占46.2%（n = 36），而下肢创伤患者占53.8%（n = 42）。腘动脉受累占28.2%，其次是肱动脉，占23.1%。52.6%的患者采用自体静脉移植进行重建。仅7.7%的病例需要植入异体材料。一般来说，受伤肢体通过外固定进行固定，随后进行二期血管重建。有效的创伤处理使截肢率降至2.6%。
