Mavroudis C, Roon A J, Baker C C, Thomas A N
J Thorac Cardiovasc Surg. 1980 Sep;80(3):342-9.
One hundred eighty-one patients with 218 acute cervicothoracic vascular injuries underwent operations for diagnosis, resuscitation, and control of hemorrhage. The patients were divided into three clinical groups depending on their clinical status. Group I consisted of 105 patients who were hemodynamically stable and able to undergo diagnostic measures: Group II consisted of 41 patients who remained unstable and required immediate operation; Group III consisted of 35 patients who were moribund and underwent emergency room thoracotomy. The mortality rates were 4% for Group I, 15% for Group II, and 80% for Group III with an overall mortality rate of 21%. Angiography was performed in 53% of the stable Group I patients. This allowed specific identification of lesions such as arteriovenous fistula in eight patients and aortic disruption in 12 patients. Thirty-five Group III patients had thoracotomy performed in the emergency room and seven survived (20%). A vigorous clinical approach is recommended to minimize morbidity. A different approach is described for each of the three clinical groups of patients.
181例患有218处急性颈胸段血管损伤的患者接受了用于诊断、复苏及控制出血的手术。根据临床状态，这些患者被分为三个临床组。第一组由105例血流动力学稳定且能够接受诊断措施的患者组成；第二组由41例仍不稳定且需要立即手术的患者组成；第三组由35例濒死且接受急诊开胸手术的患者组成。第一组的死亡率为4%，第二组为15%，第三组为80%，总体死亡率为21%。53%血流动力学稳定的第一组患者接受了血管造影。这使得能够明确识别8例患者的动静脉瘘及12例患者的主动脉破裂等病变。35例第三组患者在急诊室接受了开胸手术，7例存活（20%）。建议采取积极的临床方法以将发病率降至最低。针对三个临床组的患者分别描述了不同的方法。
