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钝性创伤(道路交通意外)导致的周围血管损伤:处理和结果。

Peripheral vascular injuries due to blunt trauma (road traffic accident): management and outcome.

机构信息

Department of Cardiovascular and Thoracic Surgery, SKIMS, Soura, India.

出版信息

Int J Surg. 2012;10(9):560-2. doi: 10.1016/j.ijsu.2012.08.018. Epub 2012 Sep 5.

Abstract

BACKGROUND

The present study was undertaken to analyze the pattern, presentation and management of peripheral vascular injuries due to road traffic accidents (RTA).

METHODS

A prospective study of patients of peripheral vascular injuries due to road traffic accidents (RTA) between Jan. 2007 to Dec. 2011. A total of 192 patients presented with peripheral vascular injuries due to RTA during this period. All patients with vascular injury due to other causes were excluded from study.

RESULTS

Most of the patients were managed by reverse saphenous vein graft followed by end to end anastomosis. Most of the patients had associated long bone fractures. Delayed presentation and associated long bone fractures had bad effect on outcome. Wound infection and thrombosis of the graft were the most important complication. Amputation rate was 4.68%.

CONCLUSION

Vascular injury due to RTA requires prompt recognition and referral to a vascular center. Immediate revascularization has excellent results and less morbidity. Proper clinical examination and hand held Doppler examination are enough to reach the diagnosis.

摘要

背景

本研究旨在分析道路交通伤(RTA)所致外周血管损伤的模式、表现和处理方法。

方法

对 2007 年 1 月至 2011 年 12 月期间因 RTA 所致外周血管损伤的患者进行前瞻性研究。共有 192 例患者因 RTA 出现外周血管损伤。所有因其他原因导致血管损伤的患者均被排除在研究之外。

结果

大多数患者采用大隐静脉逆行移植后行端端吻合术进行治疗。大多数患者伴有长骨骨折。延迟就诊和合并长骨骨折对治疗结果有不良影响。伤口感染和移植物血栓形成是最重要的并发症。截肢率为 4.68%。

结论

RTA 所致的血管损伤需要及时识别和转至血管中心。立即血运重建可获得良好的效果,且并发症少。适当的临床检查和手持多普勒检查足以做出诊断。

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