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上肢动脉创伤后功能结局的测定

Determination of functional outcome following upper extremity arterial trauma.

作者信息

Joshi Vijay, Harding Gregory E J, Bottoni David A, Lovell Marge B, Forbes Thomas L

机构信息

Division of Vascular Surgery, London Health Sciences Centre & The University of Western Ontario, London, Ontario, Canada.

出版信息

Vasc Endovascular Surg. 2007 Apr-May;41(2):111-4. doi: 10.1177/1538574406291338.

Abstract

Upper extremity arterial trauma may lead to significant disability with a poor functional outcome. This study represents a retrospective review of all trauma patients presenting to a university-affiliated medical center. Patients suffering from upper extremity arterial injuries requiring treatment were identified. The injured vessels were identified along with the mechanism of injury and method of repair. The degree of functional disability was evaluated by using a previously validated questionnaire, the Disabilities of the Arm, Shoulder, and Hand (DASH) Outcome Measure. Between September 1999 and December 2004, 17 patients presented with traumatic arterial injury to the upper extremity, with 9 and 8 patients suffering from blunt and penetrating traumas, respectively. One patient required amputation representing a limb salvage rate of 94%. The mean length of hospitalization was significantly shorter for penetrating trauma (5.1 vs 12 days, P = .03), with blunt trauma victims being more prone to coexisting orthopedic injuries (P = .009). Length of follow-up did not differ between the 2 groups and ranged from 1-60 months. Patients with blunt trauma tended, although not statistically significant, to have higher DASH scores (61.8 vs 22.8, P = .08), indicating a greater degree of disability. By utilizing a validated disability questionnaire, this study confirms that patients suffering from blunt injuries to upper extremity arteries are more likely to have greater degrees of disability affecting everyday activities.

摘要

上肢动脉创伤可能导致严重残疾,功能预后较差。本研究对所有就诊于一所大学附属医院的创伤患者进行了回顾性分析。确定了需要治疗的上肢动脉损伤患者。明确了受伤血管、损伤机制及修复方法。使用先前验证过的问卷《手臂、肩部和手部功能障碍(DASH)结局评估量表》评估功能残疾程度。1999年9月至2004年12月期间,17例患者出现上肢创伤性动脉损伤,其中9例和8例分别为钝器伤和穿透伤。1例患者需要截肢,保肢率为94%。穿透伤患者的平均住院时间显著较短(5.1天对12天,P = 0.03),钝器伤受害者更易合并骨科损伤(P = 0.009)。两组患者的随访时间无差异,范围为1至60个月。钝器伤患者的DASH评分虽无统计学意义,但有升高趋势(61.8对22.8,P = 0.08),表明残疾程度更高。通过使用经过验证的残疾问卷,本研究证实上肢动脉钝器伤患者更有可能出现影响日常活动的更高程度残疾。

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