Mitchell F L, Thal E R
Department of Surgery, University of Texas Southwestern Medical Center, Dallas.
J Trauma. 1990 Mar;30(3):336-9. doi: 10.1097/00005373-199003000-00014.
Controversy continues regarding the use of PTFE versus autogenous vein grafts in the repair of arterial injuries. This study was designed to evaluate the results of a large series of autogenous interposition vein grafts used for arterial trauma. The charts of 191 patients with 192 arterial injuries repaired with an autogenous vein graft were reviewed. Specific areas of interest included graft-related complications such as thrombosis, infection, rupture, incidence of amputation, and mortality. Seventy-six per cent of the injuries were due to penetrating trauma. Forty-five per cent involved the upper and 51% the lower extremity. Shock (B. P. less than 80) occurred in one third of the patients. There were 23 (12%) graft-related complications. Sixteen (8.3%) of the grafts thrombosed. Three of these patients required an amputation and one a nephrectomy. Seven grafts (3.6%) became infected; all seven eventually ruptured. Five of these patients required an amputation. Eighteen patients (9.4%) required amputation; however, only eight (4.2%) of these cases were graft related. One patient died from non-graft-related multiple organ failure, establishing a mortality rate of 0.5%. Based on the data reported in this series, it is concluded that autogenous grafts continue to provide a safe, readily accessible, and effective means by which selected arterial injuries can be repaired.
关于在动脉损伤修复中使用聚四氟乙烯（PTFE）与自体静脉移植物仍存在争议。本研究旨在评估大量用于动脉创伤的自体间置静脉移植物的效果。回顾了191例接受自体静脉移植物修复192处动脉损伤患者的病历。感兴趣的具体方面包括与移植物相关的并发症，如血栓形成、感染、破裂、截肢发生率和死亡率。76%的损伤是由穿透性创伤引起的。45%涉及上肢，51%涉及下肢。三分之一的患者出现休克（血压低于80）。有23例（12%）与移植物相关的并发症。16例（8.3%）移植物发生血栓形成。其中3例患者需要截肢，1例需要肾切除术。7例移植物（3.6%）发生感染；所有7例最终都破裂了。其中5例患者需要截肢。18例患者（9.4%）需要截肢；然而，这些病例中只有8例（4.2%）与移植物相关。1例患者死于与移植物无关的多器官功能衰竭，死亡率为0.5%。根据本系列报道的数据，得出结论，自体移植物仍然是一种安全、易于获取且有效的方法，可用于修复特定的动脉损伤。
