Department of Vascular Surgery, Royal Berkshire Hospital, London Road, Reading, RG1 5AN, UK.
World J Surg. 2010 Oct;34(10):2363-7. doi: 10.1007/s00268-010-0647-5.
Vascular trauma is associated with significant mortality and severe complications. Vascular injuries in the UK are infrequent, although the exact incidence remains unknown. The objective of this article is to describe patients presenting with vascular trauma to one surgeon over 21 years in a British hospital.
A retrospective review of prospectively collected data was performed and supplemented by case notes retrieval. Patients' details, including cause and nature of vascular injury, intervention, and long-term survival, were recorded. Statistical analysis was performed by comparison of survival curves using a log-rank test.
Eighty-nine patients presented, including 44 men (49%). Iatrogenic trauma accounted for 63 cases (71%) with a median age of 63 years (range = 33-91), and 51 of these cases (81%) occurred either following peripheral angioplasty (n = 40) or after cardiac catheterisation (n = 11). Within the non-iatrogenic group (n = 26), median age was 35 years (range = 15-71), with 19 cases (58%) situated in the lower limb. There were no amputations. Median survival of patients following peripheral vascular intervention was 83 months, compared with 180 months following coronary procedures. No patient died following non-iatrogenic trauma.
Vascular trauma remains a serious although uncommon phenomenon, with a trend in the UK of increasing iatrogenic trauma. To ensure the best possible outcomes, future rotas and designation of services will need to guarantee the consistent availability of a vascular surgeon. A British national registry on vascular trauma is currently lacking and would assist in identifying national trends and comparing international outcomes and epidemiology.
血管创伤与较高的死亡率和严重并发症相关。在英国，血管损伤并不常见，尽管确切的发病率尚不清楚。本文的目的是描述一位英国外科医生在 21 年时间里诊治的血管创伤患者。
对前瞻性收集的数据进行回顾性分析，并通过病历检索进行补充。记录患者的详细信息，包括血管损伤的原因和性质、干预措施以及长期生存情况。通过对数秩检验比较生存曲线进行统计学分析。
共有 89 名患者就诊，其中 44 名男性（49%）。医源性创伤占 63 例（71%），中位年龄为 63 岁（范围 33-91 岁），其中 51 例（81%）发生在外周血管成形术后（n=40）或心脏导管术后（n=11）。在非医源性组（n=26）中，中位年龄为 35 岁（范围 15-71 岁），19 例（58%）位于下肢。无截肢。外周血管介入治疗后患者的中位生存时间为 83 个月，而冠状动脉手术后的中位生存时间为 180 个月。非医源性创伤后无患者死亡。
血管创伤仍然是一种严重但不常见的现象，在英国，医源性创伤呈上升趋势。为了确保获得最佳的治疗效果，未来的轮转和服务指定需要保证血管外科医生的持续可用性。目前英国缺乏血管创伤的国家登记处，该登记处将有助于确定国家趋势，并比较国际结果和流行病学。
