Clark G C, Lim R C, Rosenburg J M
Department of Surgery, Kaiser Permanente Medical Centers, Richmond, California.
Am Surg. 1991 Sep;57(9):582-7.
One hundred consecutive patients with cervicothoracic vascular trauma were analyzed. The injury severity score, mechanism of injury, age, initial findings, management, and results were tabulated. There were 48 arterial and 61 venous injuries in the stable Group A patients, 11 arterial and 12 venous injuries in the unstable Group B patients, and three arterial and five venous injuries in the morbid Group C patients. Treatment included primary repair, resection with end-to-end anastomosis, or ligation. Twenty-three patients developed postoperative complications, the most common being respiratory in nature. The overall mortality rate was six per cent. Five patients died during or immediately after operation of exsanguination, and one died of ischemic brain death on the seventh postinjury day. The usefulness of preoperative angiograms, especially in the detection of arteriovenous fistulas, is important in planning the surgical approach. The overall outcome was favorable.
对100例连续性颈胸段血管创伤患者进行了分析。将损伤严重程度评分、损伤机制、年龄、初始检查结果、治疗方法及结果制成表格。在稳定的A组患者中，有48例动脉损伤和61例静脉损伤；不稳定的B组患者中有11例动脉损伤和12例静脉损伤；病情严重的C组患者中有3例动脉损伤和5例静脉损伤。治疗方法包括一期修复、切除后端端吻合或结扎。23例患者出现术后并发症，最常见的是呼吸系统并发症。总体死亡率为6%。5例患者在手术期间或术后立即死于失血，1例在受伤后第7天死于缺血性脑死亡。术前血管造影，尤其是在检测动静脉瘘方面的作用，对于规划手术入路很重要。总体结果良好。
