Dedichen H
Thoraxkirurgisk avdeling, Ullevål sykehus, Oslo.
Tidsskr Nor Laegeforen. 1992 Mar 30;112(9):1170-3.
The diagnosis of vascular injuries may be delayed because the symptoms are masked by other injuries or may develop gradually after the first examination took place. If serious ischemic damage is to be avoided, a high degree of diagnostic alertness is necessary, and angiography should be performed whenever vascular injuries are suspected. Most vascular injuries can be repaired by simple techniques: In our experience the most frequently used reconstruction techniques were direct suture of the artery or a longitudinal arteriotomy with thrombendarterectomy and patch plasty. In complicated injuries with much destruction of tissue, the best solution may be an extra-anatomic bypass with a prosthetic graft. Simultaneous venous injuries should be repaired and fasciotomies performed on liberal indications. Pseudoaneurysms and arteriovenous fistulae should be diagnosed and treated early.
血管损伤的诊断可能会延迟，因为症状被其他损伤所掩盖，或者可能在首次检查后逐渐出现。为避免严重的缺血性损伤，必须保持高度的诊断警觉性，一旦怀疑有血管损伤，就应进行血管造影。大多数血管损伤可用简单技术修复：根据我们的经验，最常用的重建技术是动脉直接缝合或纵行动脉切开术加血栓内膜切除术和补片成形术。在组织破坏严重的复杂损伤中，最佳解决方案可能是采用人工血管进行解剖外旁路移植术。同时存在的静脉损伤应予以修复，并根据广泛的指征进行筋膜切开术。假性动脉瘤和动静脉瘘应尽早诊断和治疗。
