Dajani O M, Haddad F F, Hajj H A, Sfeir R E, Khoury G S
Department of Surgery, American University of Beirut Medical Center, Lebanon.
Eur J Vasc Surg. 1988 Oct;2(5):293-6. doi: 10.1016/s0950-821x(88)80003-3.
Over a 10-year-period extending from January 1976 to September 1986, 800 peripheral vascular injuries were surgically treated at the American University of Beirut Medical Centre. Of these, 150 were operated on because of injury to the femoral vessels. Bullets were the commonest wounding agents (60% of cases). Thirty-seven patients had a femoral artery injury, 27 a femoral vein injury and 86 combined femoral artery and vein damage. Twenty-three per cent of the patients had an associated fracture of the femur. Patients with fractures had an 11% amputation rate compared with 1% for those without fractures. Our data reveals the importance of venous reconstruction in the presence of an arterial injury instead of its ligation (P less than 0.05), particularly when there is an associated fracture of the femur. Thirty-seven per cent of patients were in shock on admission (systolic BP 90 mmHg). The amputation rate in these patients was 6.8% in contrast to 1% in the haemodynamically stable group (P less than 0.05). The overall amputation rate was 3.3%. Complications occurred in 36.6% of patients and the mortality was 4.0%.
在1976年1月至1986年9月的10年期间，美国贝鲁特大学医学中心对800例周围血管损伤进行了手术治疗。其中，150例因股血管损伤而接受手术。子弹是最常见的致伤因素（占病例的60%）。37例患者有股动脉损伤，27例有股静脉损伤，86例有股动脉和股静脉联合损伤。23%的患者伴有股骨骨折。有骨折的患者截肢率为11%，而无骨折的患者截肢率为1%。我们的数据显示，在存在动脉损伤时进行静脉重建而非结扎的重要性（P<0.05），特别是当伴有股骨骨折时。37%的患者入院时处于休克状态（收缩压90mmHg）。这些患者的截肢率为6.8%，而血流动力学稳定组为1%（P<0.05）。总体截肢率为3.3%。36.6%的患者发生并发症，死亡率为4.0%。
