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采用大隐静脉移植成功挽救了挤压伤的上肢并重建了肱动脉损伤。

Successful salvage of a crushed upper limb and reconstruction of brachial artery injury using a saphenous venous graft.

作者信息

AlSinan Fatima Mufid, Alshowaiey Rana Ali, Alsaqer Mohammed Abdullah, Abdelmohsen Abdelhalim A

机构信息

Department of General Surgery, Dammam Medical Complex, Dammam, Saudi Arabia.

Department of Vascular Surgery, Dammam Medical Complex, Dammam, Saudi Arabia.

出版信息

J Vasc Surg Cases Innov Tech. 2025 Mar 17;11(3):101786. doi: 10.1016/j.jvscit.2025.101786. eCollection 2025 Jun.

DOI:10.1016/j.jvscit.2025.101786
PMID:40256201
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC12008680/
Abstract

A crushed upper limb presents a rare entity seen in trauma patients, often resulting in a significant functional disability. We report a case of a 28-year-old male patient who presented with a crush injury to his upper limb after sustaining a motor vehicle accident. Computed tomography angiography showed an abrupt cutoff of the brachial artery proximal to the elbow joint with no contrast filling distally. Revascularization was successfully done using a saphenous venous graft. This case describes a successful revascularization attempt beyond the golden 6 hours.

摘要

上肢挤压伤是创伤患者中罕见的情况，常导致严重的功能残疾。我们报告一例28岁男性患者，在遭遇机动车事故后出现上肢挤压伤。计算机断层血管造影显示肘关节近端肱动脉突然中断，远端无造影剂充盈。使用大隐静脉移植物成功进行了血运重建。该病例描述了在黄金6小时之后成功进行血运重建的尝试。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/bab0/12008680/332dd28120e6/gr3.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/bab0/12008680/5ea38a33b503/gr1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/bab0/12008680/0e296abb677d/gr2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/bab0/12008680/332dd28120e6/gr3.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/bab0/12008680/5ea38a33b503/gr1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/bab0/12008680/0e296abb677d/gr2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/bab0/12008680/332dd28120e6/gr3.jpg

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本文引用的文献

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Rare brachial artery injury caused by blunt trauma; a case of the brachial artery laceration in an amateur volleyball player.钝性创伤导致的罕见肱动脉损伤；一名业余排球运动员肱动脉撕裂伤病例
Trauma Case Rep. 2021 Dec 8;37:100570. doi: 10.1016/j.tcr.2021.100570. eCollection 2022 Feb.
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Primary amputation versus limb salvage in upper limb major trauma: a systematic review.上肢严重创伤中初次截肢与保肢治疗的比较：一项系统评价。
Eur J Orthop Surg Traumatol. 2022 Apr;32(3):395-403. doi: 10.1007/s00590-021-03008-x. Epub 2021 May 29.
3
Upper Limb Salvage of a Mangled Limb with Reconstruction of Brachial, Ulnar and Radial Arteries Using an Extremely Long Reversed Bifurcated Great Saphenous Vein: A Case Report with Long-Term Follow-Up.
使用极长的逆行分叉大隐静脉重建肱动脉、尺动脉和桡动脉对严重毁损肢体进行上肢挽救：一项长期随访的病例报告
Int J Gen Med. 2020 Nov 24;13:1235-1241. doi: 10.2147/IJGM.S280616. eCollection 2020.
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Successful salvage of the upper limb after crush injury requiring nine operations: a case report.挤压伤后上肢成功挽救，需进行九次手术：一例病例报告。
Int Surg. 2015 Mar;100(3):540-6. doi: 10.9738/INTSURG-D-14-00018.1.
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Scand J Trauma Resusc Emerg Med. 2008 Nov 25;16:16. doi: 10.1186/1757-7241-16-16.
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The validity of the mangled extremity severity score in the assessment of upper limb injuries.严重肢体损伤严重程度评分在评估上肢损伤中的有效性。
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Nerve injury associated with acute vascular trauma.
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