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创伤领域医源性血管损伤的病例报告:相同点与不同点是什么?

Case reports of iatrogenic vascular injury in the trauma field: what is the same and what is different?

作者信息

Kim Youngwoong, Choi Kyunghak, Choi Seongho, Keum Min Ae, Kim Sungjeep, Kyoung Kyu-Hyouck, Kim Jihoon T, Noh Minsu

机构信息

Department of Thoracic and Cardiovascular Surgery, Ulsan University Hospital, University of Ulsan College of Medicine, Ulsan, Korea.

Department of Trauma Surgery, Ulsan University Hospital, University of Ulsan College of Medicine, Ulsan, Korea.

出版信息

J Trauma Inj. 2022 Jun;35(2):123-127. doi: 10.20408/jti.2021.0088. Epub 2021 Dec 24.

Abstract

Iatrogenic vascular injury (IVI) can occur with any technique or type of surgery performed around a blood vessel. Patients with severe trauma are at risk of IVI. In this study, we describe our experiences of IVI in the trauma field. We reviewed five patients who were diagnosed with an IVI and received either surgical or endovascular treatment. Of the five patients, one had an arterial injury, three had venous injuries, and one had an arteriovenous fistula, a form of combined arterial and venous injuries. Of the five patients, four had undergone orthopedic surgery. The IVIs of three patients were immediately identified in the operating room and simultaneous vascular repair was performed. The remaining one patient underwent additional surgery for occlusion related to entrapment of the superficial femoral artery by a surgical wire used during orthopedic surgery. Complications presumably related to the IVI were identified in two patients. IVI in trauma patients can be successfully managed, but significant morbidity can occur. If an IVI is suspected, immediate evaluation and management are required.

摘要

医源性血管损伤(IVI)可发生于在血管周围进行的任何手术技术或手术类型中。严重创伤患者存在IVI风险。在本研究中,我们描述了我们在创伤领域处理IVI的经验。我们回顾了5例被诊断为IVI并接受手术或血管内治疗的患者。5例患者中,1例有动脉损伤,3例有静脉损伤,1例有动静脉瘘,这是一种动脉和静脉联合损伤的形式。5例患者中有4例接受了骨科手术。3例患者的IVI在手术室中被立即识别并同时进行了血管修复。其余1例患者因骨科手术中使用的手术钢丝导致股浅动脉受压而进行了额外的闭塞手术。2例患者出现了可能与IVI相关的并发症。创伤患者的IVI可以得到成功处理,但可能会出现严重的发病率。如果怀疑有IVI,需要立即进行评估和处理。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c13b/11309190/c945176a7740/jti-2021-0088f1.jpg

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