Weaver F A, Yellin A E, Bauer M, Oberg J, Ghalambor N, Emmanuel R P, Applebaum R M, Pentecost M J, Shorr R M
Department of Surgery, University of Southern California School of Medicine, Los Angeles 90033.
Arch Surg. 1990 Oct;125(10):1256-60. doi: 10.1001/archsurg.1990.01410220040006.
Three hundred seventy-three patients with a penetrating extremity injury were studied to assess the yield of arteriography. Patients underwent arteriography if any of the following was present: bruit, history of hemorrhage or hypotension, fracture, hematoma, decreased capillary refill, major soft-tissue injury, or nerve or pulse deficit. In the absence of these findings, arteriography was performed if the injury was in "proximity" to a major neurovascular bundle. In 216 patients, arteriography was performed when an abnormal finding was noted. Sixty-five injuries were identified, 19 requiring intervention. Proximity was the indication for arteriography in 157 patients. Seventeen injuries were identified, of which one required repair. In penetrating extremity trauma, the need for arteriography is based on clinical findings. The use of arteriography to screen for an arterial injury when proximity alone is the indication rarely identifies a significant injury and should be abandoned.
对373例四肢穿透伤患者进行了研究，以评估动脉造影的诊断价值。若患者出现以下任何一种情况，则接受动脉造影检查：有血管杂音、有出血或低血压病史、骨折、血肿、毛细血管再充盈时间延长、严重软组织损伤、神经或脉搏缺失。若未出现上述情况，但损伤部位“靠近”主要神经血管束，则也需进行动脉造影检查。216例患者在发现异常情况时接受了动脉造影检查。共发现65处损伤，其中19处需要干预治疗。157例患者因损伤部位靠近主要神经血管束而接受动脉造影检查，共发现17处损伤，其中1处需要修复。在四肢穿透伤中，是否需要进行动脉造影检查应基于临床检查结果。仅以损伤部位靠近主要神经血管束为指征进行动脉造影筛查，很少能发现严重损伤，因此应摒弃这种做法。
