Li Zhui, Zhao Liang, Wang Kaizhen, Cheng Jun, Zhao Yu, Ren Wei
Department of Vascular Surgery, The First Affiliated Hospital of Chongqing Medical University Chongqing 400016, China.
Int J Clin Exp Med. 2014 Dec 15;7(12):4710-9. eCollection 2014.
To assess clinical characteristics and treatment outcomes of patients with vascular injuries.
We retrospectively reviewed the medical records of 378 consecutive patients with vascular injuries treated at our hospital from January 2000 to December 2012. Basic characteristics (such as gender; age; cause, site, and type of injury; and concomitant injuries) were recorded, and efficacy was compared between treatments for same type/site injuries.
Vascular injuries occurred most frequently in patients aged 19-50 years, secondary to trauma, and in extremities (73%, 63%, and 84% of cases, respectively), particularly lower ones. Amputation was more common in popliteal artery injury (52.6% of cases); overall, inappropriate diagnosis or treatment or poor vascular anastomosis led to amputation in 17 cases. Extremity vascular patency, while comparable at 12 months, was significantly lower at 24 months after artificial blood-vessel implantation than autogenous vein grafting. Treatment of femoral artery pseudoaneurysm secondary to drug abuse yielded similar amputation but significantly lower limb ischemia rates after bypass graft surgery than arterial ligation.
Initial and temporal outcome differentiation reported here for treatments for peripheral vascular injuries according to type and site underscores the importance of further defining treatment choice consequences, particularly long term ones because most affected patients are aged 19-50 years old.
评估血管损伤患者的临床特征及治疗效果。
我们回顾性分析了2000年1月至2012年12月在我院连续治疗的378例血管损伤患者的病历。记录基本特征(如性别、年龄、损伤原因、部位和类型以及合并伤),并比较相同类型/部位损伤的不同治疗方法的疗效。
血管损伤最常发生于19 - 50岁的患者,多由创伤引起,且多发生于四肢(分别占病例的73%、63%和84%),尤其是下肢。腘动脉损伤患者截肢更为常见(占病例的52.6%);总体而言,诊断或治疗不当或血管吻合不佳导致17例患者截肢。人工血管植入术后12个月时肢体血管通畅情况与自体静脉移植相当,但术后24个月时明显低于后者。药物滥用继发的股动脉假性动脉瘤,旁路移植手术后截肢情况相似,但肢体缺血率明显低于动脉结扎术。
本文报道的根据外周血管损伤类型和部位进行治疗的初始及随访结果差异,凸显了进一步明确治疗选择后果的重要性,尤其是长期后果,因为大多数受影响患者年龄在19 - 50岁。