Weaver F A, Suda R W, Stiles G M, Yellin A E
Department of Surgery, Los Angeles County/University of Southern California Medical Center 90033.
Surg Gynecol Obstet. 1989 Jul;169(1):27-31.
During the past decade (1977 to 1987), 46 patients with 51 arterial injuries to the ascending aorta, aortic arch and great vessels have been treated at our institution. There were 25 subclavian arterial, 17 common carotid arterial, five innominate arterial and four ascending aortic injuries. Sixteen (35 per cent) patients were hemodynamically unstable at admission and required immediate operative intervention. Two patients arrived in cardiac arrest, necessitating thoracotomy performed in the emergency room. Thirty (65 per cent) patients were hemodynamically stable and underwent emergent diagnostic angiography prior to arterial repair. Lateral or end to end arterial repairs were used in the majority. Two ascending aortic injuries required cardiopulmonary bypass. Forty-three of 46 patients survived. Prompt exploration in the unstable patient, diagnostic angiography in the stable patient and a systematic but flexible operative approach are the keys to the management of these potentially lethal injuries.
在过去十年（1977年至1987年）间，我院共治疗了46例升主动脉、主动脉弓及大血管动脉损伤患者，损伤共计51处。其中锁骨下动脉损伤25处，颈总动脉损伤17处，无名动脉损伤5处，升主动脉损伤4处。16例（35%）患者入院时血流动力学不稳定，需要立即进行手术干预。2例患者到达时心脏骤停，需在急诊室行开胸手术。30例（65%）患者血流动力学稳定，在动脉修复前接受了急诊诊断性血管造影。大多数采用侧方或端端动脉修复。2例升主动脉损伤需要体外循环。46例患者中有43例存活。对不稳定患者迅速进行探查，对稳定患者进行诊断性血管造影，以及采用系统但灵活的手术方法是处理这些潜在致命损伤的关键。
