Siddique Muhammad Khalid, Bhatti Ahsin Manzoor
Department of General and Vascular Surgery, Combined Military Hospital, Rawalpindi Cantt.
J Pak Med Assoc. 2013 Mar;63(3):327-30.
To assess the presentation, diagnostic evaluation, various techniques of vascular repair and their outcomes.
The prospective descriptive study was conducted at the Combined Military Hospital, Rawalpindi, from October 2008 to December 2010. It involved 54 patients with vascular injuries in the extremities who underwent various vascular surgical interventions.Those who presented with irreversible ischaemia or had primary amputation and presented late with missed vascular injuries were excluded. The cases were evaluated for mechanism of injury, site and type of injury, associated injuries, type of repair performed and its outcome. Mean with standard deviation and frequency and percentage was calculated wherever relevant.
The mean age of 54 patients was 26.8 +/- 9.2 years (range: 9-67 years), and the male-to-female ratio was 17:1. Penetrating trauma was the most common cause (n=34; 62.9%). Lower extremities were affected more commonly (n=33; 61.1%) and superficial femoral artery was the most frequently involved vessel (n=14; 25.9%). Besides, 16 (29.6%) patients had associated fractures, while concomitant venous injuries were present in 12 (22.2%). Interposition autogenous saphenous vein graft was the most common type of repair performed (n=42; 77.7%). Prosthetic graft was used only in 3 (5.5%) patients. Wound infection was the common complication (n=6; 11.1%). Three (5.5%) patients had secondary amputation and 2 (3.7%) died due to associated injuries. Vascular reconstruction was successful in 49 (90.7%) cases.
Early recognition and re-vascularisation by a vascular surgeon hold the key to saving more than 90% limbs with vascular injuries.
评估血管损伤的表现、诊断评估、各种血管修复技术及其结果。
2008年10月至2010年12月在拉瓦尔品第联合军事医院进行前瞻性描述性研究。研究纳入54例接受各种血管外科手术干预的四肢血管损伤患者。排除那些出现不可逆缺血或已行一期截肢以及因血管损伤漏诊而就诊较晚的患者。对病例进行损伤机制、损伤部位和类型、合并损伤、所进行的修复类型及其结果的评估。在相关情况下计算均值及标准差、频率和百分比。
54例患者的平均年龄为26.8±9.2岁（范围：9 - 67岁），男女比例为17∶1。穿透伤是最常见的原因（n = 34；62.9%）。下肢更常受累（n = 33；61.1%），股浅动脉是最常受累的血管（n = 14；25.9%）。此外，16例（29.6%）患者合并骨折，12例（22.2%）伴有静脉损伤。自体大隐静脉移植搭桥是最常见的修复方式（n = 42；77.7%）。仅3例（5.5%）患者使用了人工血管。伤口感染是常见并发症（n = 6；11.1%）。3例（5.5%）患者进行了二期截肢，2例（3.7%）患者因合并损伤死亡。49例（90.7%）血管重建成功。
血管外科医生的早期识别和血管再通是挽救90%以上血管损伤肢体的关键。
