Vasquez G, Pollinzi V, Ortolani M, Ghisellini G, Marescotti R, Stabellini A, Castaldini C
Istituto di Semeiotica Chirurgica, Università degli Studi di Ferrara.
G Chir. 1990 Oct;11(10):565-9.
Progress in the management of complex vascular injuries of the limbs has not eliminated the necessity for amputations. Physicians' failure to suspect vascular injury on admission in traumatized patients causes delay in the diagnosis and management of arterial injury that ultimately leads to limb loss. High index of suspicion, early recognition by clinical evaluation, routine use of Doppler flowmeter and broad indication of preoperative angiography result in prompt repair of these lesions in the majority of cases. In managing the lower popliteal or trifurcation vessels, distal radial and ulnar artery as well as nerve injuries, the Authors believe microsurgical techniques should always be employed.
四肢复杂血管损伤治疗方面的进展并未消除截肢的必要性。医生在创伤患者入院时未怀疑血管损伤,导致动脉损伤的诊断和治疗延迟,最终导致肢体丧失。高度的怀疑指数、通过临床评估进行早期识别、常规使用多普勒流量计以及术前血管造影的广泛指征,使得大多数此类损伤能够得到及时修复。在处理腘动脉下段或分叉血管、桡尺动脉远端以及神经损伤时,作者认为应始终采用显微外科技术。