Toy Jonathan, Ball Brandon J, Tredget Edward E
Division of Plastic and Reconstructive Surgery, Department of Surgery, University of Alberta, Edmonton, Canada.
J Burn Care Res. 2012 May-Jun;33(3):e160-5. doi: 10.1097/BCR.0b013e318239ca75.
Electrical injuries often result in extensive tissue damage where vascular damage may occur and result in thrombosis and spontaneous rupture of blood vessels. Rupture of the brachial, radial, ulnar, internal mammary, and obturator arteries has been reported in the literature. The authors present two cases of carotid artery rupture following high-voltage electrical injuries. The first case is a 21-year-old man who was climbing a fence near a high-voltage power line when a gold chain he was wearing around his neck caught on the power line, resulting in a 10% circumferential electrical injury to his neck. He presented with visible arterial bleeding from the large neck wound and was taken to the operating room, where a 1-cm laceration to the carotid artery was repaired with a vein patch. On the second postoperative day, the patch dislodged, and a spontaneous rupture of the common carotid artery occurred. The damaged artery was subsequently ligated. The patient recovered with no neurological sequelae. The second case is a 43-year-old man who suffered a high-voltage injury while working on an electrical panel, resulting in a 50% TBSA full-thickness burn to the face, scalp, trunk, and extremities. Four weeks after admission, a latissimus dorsi myocutaneous free flap was used for coverage of exposed outer table of the skull. Intraoperatively, the carotid artery spontaneously ruptured proximal to where the dissection was being carried out. The patient recovered with no neurological sequelae. High-voltage electrical injury results in significant damage to blood vessels via a number of mechanisms. Rupture of a major vessel is a rare, life-threatening sequelae of electrical injury.
电损伤常导致广泛的组织损伤，其中血管损伤可能发生并导致血栓形成和血管自发性破裂。文献中已报道肱动脉、桡动脉、尺动脉、胸廓内动脉和闭孔动脉的破裂。作者介绍了两例高压电损伤后颈动脉破裂的病例。第一例是一名21岁男性，他在靠近高压电线的围栏处攀爬时，脖子上戴的金项链挂在了电线上，导致其颈部10%的环形电损伤。他因颈部大伤口可见动脉出血前来就诊，并被送往手术室，在那里用静脉补片修复了颈动脉1厘米的撕裂伤。术后第二天，补片脱落，颈总动脉发生自发性破裂。随后结扎了受损动脉。患者康复，无神经后遗症。第二例是一名43岁男性，他在电气面板上工作时遭受高压电损伤，导致面部、头皮、躯干和四肢50%的体表面积全层烧伤。入院四周后，采用背阔肌肌皮游离皮瓣覆盖暴露的颅骨外板。术中，颈动脉在进行解剖的近端自发破裂。患者康复，无神经后遗症。高压电损伤通过多种机制导致血管严重损伤。大血管破裂是电损伤罕见的、危及生命的后遗症。
