Asensio Juan A, Petrone Patrizio, Kimbrell Brian, Kuncir Eric
Division of Trauma and Surgical Critical Care, Department of Surgery, University of Southern California Keck School of Medicine, Los Angeles County-University of Southern California Medical Center, Los Angeles, CA 90033-4525, USA.
South Med J. 2005 Apr;98(4):462-6. doi: 10.1097/01.SMJ.0000136239.16913.C2.
Celiac axis injuries are rare. The purposes of this study were to (1) review institutional experience, (2) determine additive effect on death of associated vessel injuries, and (3) correlate mortality rates with the American Association for the Surgery of Trauma-Organ Injury Scale (AAST-OIS) for abdominal vascular injury.
This was a retrospective, 132-month study (January 1992 to December 2002) of patients with celiac axis injuries.
Thirteen patients were included in the study. Mean revised trauma score was 5.35+/-2.63; mean injury severity score was 25+/-12. The mechanism was penetrating in 12 (92%) and blunt in 1 (8%); 3 of 13 had Emergency Department thoracotomy (100% mortality rate). Treatment included ligation in 11 and primary repair in 1; 1 exsanguinated. Overall survival was 5 of 13 (38%). Adjusted survival excluding patients who had Emergency Department thoracotomy was 5 of 10 patients (50%). Those surviving with isolated injuries included 57% of patients. Mortality rate versus AAST-OIS was grade III, 43% (3 of 7 patients); grade IV, 50% (1 of 2 patients); and grade V, 100% (4 of 4 patients).
Celiac axis injuries are rare. Patients with isolated injuries have better survival rates. Mortality rate correlates well with AAST-OIS for abdominal vascular injury.
腹腔干损伤较为罕见。本研究的目的是：（1）回顾机构经验；（2）确定相关血管损伤对死亡的附加影响；（3）将死亡率与美国创伤外科协会器官损伤评分（AAST - OIS）对腹部血管损伤的评分相关联。
这是一项对腹腔干损伤患者进行的回顾性研究，为期132个月（1992年1月至2002年12月）。
13例患者纳入研究。平均修正创伤评分为5.35±2.63；平均损伤严重程度评分为25±12。致伤机制为穿透伤12例（92%），钝性伤1例（8%）；13例中有3例行急诊开胸手术（死亡率100%）。治疗包括结扎11例，一期修复1例；1例因失血过多死亡。总体生存率为13例中的5例（38%）。排除行急诊开胸手术的患者后调整后的生存率为10例患者中的5例（50%）。单纯损伤存活的患者占患者总数的57%。死亡率与AAST - OIS的关系为：Ⅲ级，43%（7例中的3例）；Ⅳ级，50%（2例中的1例）；Ⅴ级，100%（4例中的4例）。
腹腔干损伤罕见。单纯损伤的患者生存率较高。死亡率与腹部血管损伤的AAST - OIS评分密切相关。
