Burch J M, Feliciano D V, Mattox K L, Edelman M
Cora and Webb Mading Department of Surgery, Baylor College of Medicine, Houston, Texas 77030.
Am J Surg. 1988 Dec;156(6):548-52. doi: 10.1016/s0002-9610(88)80550-6.
Beginning in 1946, 577 patients with inferior vena cava injuries were managed at a single institution. After decreasing from 37 to 30 percent, the mortality rate showed a distinct increase in the last 7 years studied. This increase was related to an increasing percentage of patients who arrived in the emergency center in severe shock and required resuscitative thoracotomy. In-hospital care advances have not kept pace with improvements in prehospital care. Although venous complications have not been infrequent, morbidity has not been a significant long-term problem. Fatal pulmonary embolism occurred and was a special problem for patients over the age of 50. More basic research is needed to expedite diagnosis and vascular control in addition to understanding and treating the severe metabolic problems of patients dying from shock and hemorrhage.
从1946年开始，一家机构对577名下腔静脉损伤患者进行了治疗。死亡率从37%降至30%后，在研究的最后7年中出现了明显上升。这种上升与到达急诊中心时处于严重休克状态且需要进行复苏性开胸手术的患者比例增加有关。院内护理的进步未能跟上院前护理的改善步伐。尽管静脉并发症并不罕见，但发病率并不是一个严重的长期问题。发生了致命性肺栓塞，这对50岁以上的患者来说是一个特殊问题。除了了解和治疗因休克和出血而死亡的患者的严重代谢问题外，还需要更多的基础研究来加快诊断和血管控制。
