Gümbel D, Naundorf M, Napp M, Ekkernkamp A, Seifert J
Klinik und Poliklinik für Chirurgie, Abteilung für Unfall- und Wiederherstellungschirurgie, Universitätsmedizin Greifswald, Ferdinand-Sauerbruch-Straße, 17475, Greifswald, Deutschland,
Unfallchirurg. 2014 May;117(5):445-59; quiz 460. doi: 10.1007/s00113-014-2560-0.
Peripheral vascular injuries are the cause of high morbidity in trauma patients. Up to 5 % of all patients with injuries of the extremities present with concomitant vascular lesions. While open peripheral vascular injuries are associated with a high mortality at the scene of the accident, closed vascular injuries present the danger of developing critical tissue ischemia with a high risk of amputation and limb loss. Early diagnosis is crucial in order to rapidly restore and maintain adequate blood flow and downstream tissue perfusion. A correct diagnosis and early treatment of peripheral vascular injuries place enormous demands on interdisciplinary teams consisting of emergency physicians, orthopedic surgeons, vascular surgeons, anesthesiologists and radiologists. The top priority in the context of emergency care is hemorrhage control by applying direct pressure and dressings until definitive surgical treatment. Hypovolemic shock, reperfusion injury and compartment syndrome are complications of peripheral vascular injuries that must be recognized and treated in the early stages.
周围血管损伤是创伤患者高发病率的原因。在所有四肢受伤的患者中，高达5%伴有血管损伤。开放性周围血管损伤在事故现场死亡率很高，而闭合性血管损伤则有发展为严重组织缺血的危险，截肢和肢体丧失风险很高。早期诊断至关重要，以便迅速恢复并维持充足的血流和下游组织灌注。正确诊断和早期治疗周围血管损伤对由急诊医师、骨科医生、血管外科医生、麻醉师和放射科医生组成的跨学科团队提出了巨大要求。在急诊护理中，首要任务是通过施加直接压力和敷料控制出血，直至进行确定性手术治疗。低血容量性休克、再灌注损伤和骨筋膜室综合征是周围血管损伤的并发症，必须在早期阶段予以识别和治疗。
