Sirinek K R, Levine B A, Gaskill H V, Root H D
J Trauma. 1981 May;21(5):339-44. doi: 10.1097/00005373-198105000-00001.
During the 5-year period ending December 1978, 390 patients were explored for suspected vascular injury either in the neck or in one of the extremities with 13% morbidity and a 1% mortality rate. Positive exploration for vascular injury in 139 patients (36%) resulted in 28% morbidity and 2% mortality. Negative exploration in 251 patients (64%) was associated with a 5% morbidity and 0.4% mortality. Per cent positive exploration by type of injury was: iatrogenic injury (100%), foreign body laceration (100%), blunt trauma (79%), stab wound (32%), and gunshot wound (31%). Per cent positive exploration by area was: brachium (68%), popliteal area (63%), femoral area (28%), axilla (27%), and neck (25%). Routine exploration of patients at risk for vascular injury can be accomplished with minimal morbidity and mortality but is associated with a low (36%) diagnostic yield. 'Exclusion' arteriography in hemodynamically stable patients with equivocal signs of vascular injury appears to be indicated to increase diagnostic accuracy.
在截至1978年12月的5年期间，390例因怀疑颈部或四肢血管损伤而接受探查的患者，其发病率为13%，死亡率为1%。139例（36%）血管损伤探查阳性的患者，发病率为28%，死亡率为2%。251例（64%）探查阴性的患者，发病率为5%，死亡率为0.4%。按损伤类型划分的探查阳性百分比为：医源性损伤（100%）、异物切割伤（100%）、钝性创伤（79%）、刺伤（32%）和枪伤（31%）。按部位划分的探查阳性百分比为：上臂（68%）、腘窝区（63%）、股部（28%）、腋窝（27%）和颈部（25%）。对有血管损伤风险的患者进行常规探查，可将发病率和死亡率降至最低，但诊断阳性率较低（36%）。对于血管损伤体征不明确但血流动力学稳定的患者，“排除性”动脉造影似乎有助于提高诊断准确性。
