Fiève G, Brice M, Cazaigne J
Acta Chir Belg. 1984 Mar-Apr;84(2):67-72.
The authors report 38 observations of vascular traumatisms associated to osteo-articular lesions of lower members cured by restorative treatment. The authors define a diagnostic and therapeutic line of conduct. They insisted upon the necessity of early diagnosis of vascular lesion, based on ultrasonic exploration of vessels as soon as the patient was admitted to hospital. Restoration must be considered from a global point of view in taking into account the state of integuments , the type of selected osseous restoration, the vascular approach and the possible necessity of aponeurotomy . The importance of vascular lesion and the slowness of circulation restoration induced the results of the treatment, the major risks of which were infection and metabolic lesion of the kidney. In 18% of the cases amputation was necessary.
作者报告了38例与下肢骨关节损伤相关的血管创伤经修复治疗后痊愈的观察病例。作者定义了一套诊断和治疗行为准则。他们强调了血管损伤早期诊断的必要性,患者入院后应立即进行血管超声检查。修复必须从整体角度考虑,要兼顾皮肤状况、所选骨修复类型、血管入路以及可能需要的腱膜切开术。血管损伤的严重性和血液循环恢复的缓慢影响了治疗结果,治疗的主要风险是感染和肾脏代谢性损伤。在18%的病例中,截肢是必要的。