Rose S C, Moore E E
Department of Radiology, Denver General Hospital, Colorado.
Cardiovasc Intervent Radiol. 1988 Jun;11(3):136-9. doi: 10.1007/BF02577103.
A review of angiographic studies of 227 consecutive injured patients suspected of having sustained extremity arterial trauma was done to determine whether knowledge of the mechanisms of injury was of use in the establishment of priority in multiply injured patients. Stab wounds and other lacerations occurred in 32 patients. Major arterial injury occurred in only 3 (12%) cases; in no case was arterial occlusion present or limb viability threatened. These injuries may be angiographically evaluated on a nonurgent basis. Alternatively, patients with gunshot wounds (130 patients) and blunt injuries (63 patients) had a high incidence of major arterial injury (18 and 38%, respectively), especially arterial occlusion (15 and 24%, respectively) as well as a significant incidence of threatened limb viability (5 and 21%, respectively). Disproportionately increased risk of arterial injury occurred in patients with high-energy gunshot wounds (75%), motorcycle accidents (62%), and crush injuries (63%). Patients who sustain gunshot wounds or blunt injuries and have an abnormal vascular physical examination should be evaluated angiographically on an urgent basis.
对227例连续的疑似肢体动脉创伤的受伤患者进行血管造影研究回顾，以确定了解损伤机制是否有助于确定多发伤患者的救治优先级。32例患者发生刺伤和其他撕裂伤。仅3例（12%）发生主要动脉损伤；无一例出现动脉闭塞或肢体存活受到威胁。这些损伤可在非紧急情况下进行血管造影评估。相比之下，枪伤患者（130例）和钝性损伤患者（63例）主要动脉损伤的发生率较高（分别为18%和38%），尤其是动脉闭塞（分别为15%和24%），以及肢体存活受到威胁的发生率也较高（分别为5%和21%）。高能枪伤患者（75%）、摩托车事故患者（62%）和挤压伤患者（63%）发生动脉损伤的风险不成比例地增加。遭受枪伤或钝性损伤且血管体格检查异常的患者应紧急进行血管造影评估。
