Kudsk K A, Sheldon G F, Lim R C
J Trauma. 1982 Feb;22(2):81-5. doi: 10.1097/00005373-198202000-00001.
Since 1968 the atrial-caval shunt (ACS), along with inflow occlusion at the porta hepatis, has been used at San Francisco General Hospital in 18 trauma patients to control massive hemorrhage from the inferior vena cava, hepatic veins, or liver. Thirteen patients died from irreversible shock. Five patients survived their initial injuries; one of them died 45 days later from the complications of shock and sepsis. No patients survived who sustained blunt trauma and were admitted in cardiac arrest. Only one of ten patients with BP less than 70 mm Hg after resuscitation survived, whereas four of eight with BP greater than 70 mm Hg survived. ACS was used to control caval injuries in seven patients (one survivor), severe hepatic parenchymal fractures in four patients (two survivors), and combined hepatic and caval injuries in seven patients (two survivors). Survivors had an average of 5.75 associated injuries; nonsurvivors had 3.8. No complications of ACS occurred in the surviving patients.
自1968年以来，心房-腔静脉分流术（ACS）以及肝门入流阻断术，已被用于旧金山综合医院的18例创伤患者，以控制来自下腔静脉、肝静脉或肝脏的大量出血。13例患者死于不可逆性休克。5例患者在初次受伤后存活；其中1例在45天后死于休克和脓毒症并发症。遭受钝性创伤且入院时心脏骤停的患者无一存活。复苏后血压低于70 mmHg的10例患者中仅1例存活，而血压高于70 mmHg的8例患者中有4例存活。ACS用于控制7例患者的腔静脉损伤（1例存活）、4例患者的严重肝实质骨折（2例存活）以及7例患者的肝和腔静脉联合损伤（2例存活）。存活患者平均有5.75处合并伤；非存活患者有3.8处。存活患者未发生ACS相关并发症。
