Wang X W, Bartle E J, Roberts B B
Department of Surgery, University of Colorado Health Sciences Center, Denver 80262.
J Burn Care Rehabil. 1987 Sep-Oct;8(5):391-4. doi: 10.1097/00004630-198709000-00011.
Early vascular grafting has been used to reestablish circulation to the hand in the treatment of electric injuries of the wrist with arterial damage. Since 1972 this therapy has yielded good results by preventing necrosis of the injured hand and by helping to maintain function. However, the indications and timing for performing this operation still are poorly defined. The surgeon is faced with the difficult task of determining whether the injury is severe enough to affect distal circulation and thereby lead to necrosis. The lack of reliable clinical signs is chiefly responsible for this difficulty; however, the potential for delayed thrombosis of vessels complicates the problem. In this article, indications for early vascular grafting in an electrically injured wrist are discussed based on recent clinical experience, with emphasis on the use of arteriography. A case history involving electric burns of both upper extremities is presented as an illustration.
早期血管移植已被用于在伴有动脉损伤的腕部电损伤治疗中重建手部血液循环。自1972年以来，这种疗法通过防止受伤手部坏死并帮助维持功能取得了良好效果。然而，进行该手术的适应症和时机仍不明确。外科医生面临着确定损伤是否严重到足以影响远端血液循环并进而导致坏死的艰巨任务。缺乏可靠的临床体征是造成这一困难的主要原因；然而，血管延迟血栓形成的可能性使问题更加复杂。在本文中，基于近期临床经验讨论了腕部电损伤早期血管移植的适应症，重点是动脉造影的应用。文中给出了一个涉及双上肢电烧伤的病例作为例证。
