腘动脉损伤截肢的预测因素。
Predictors of amputation for popliteal artery injuries.
作者信息
Fainzilber G, Roy-Shapira A, Wall M J, Mattox K L
机构信息
Cora and Webb Mading Department of Surgery, Baylor College of Medicine, Houston, Texas 77030, USA.
出版信息
Am J Surg. 1995 Dec;170(6):568-70; discussion 570-1. doi: 10.1016/s0002-9610(99)80017-8.
BACKGROUND
Popliteal artery injuries continue to result in limb loss. This study identifies risk factors that predict amputation.
METHODS
Over a 5-year period, a retrospective chart review was conducted of 80 consecutive patients with 81 popliteal artery injuries.
RESULTS
The overall amputation rate was 16.5%. Blunt trauma carried a higher rate of amputation (47%) than penetrating injuries (6.2%); P < 0.0001). Associated fractures had a higher amputation rate, regardless of mechanism (odds ratio +2.7, 95% confidence limits 1.2 to 6.2). Fasciotomy at the time of operation was associated with reduced amputation rate.
CONCLUSIONS
Blunt injuries and associated fractures carry an increased risk for amputation. Compartmental pressures should be appropriately monitored postoperatively. Fasciotomy at the time of vascular repair may be considered even without evidence of compartment syndrome.
背景
腘动脉损伤仍会导致肢体丧失。本研究确定了预测截肢的危险因素。
方法
在5年期间，对连续80例有81处腘动脉损伤的患者进行了回顾性病历审查。
结果
总体截肢率为16.5%。钝性创伤的截肢率（47%）高于穿透伤（6.2%）；P<0.0001）。无论损伤机制如何，合并骨折的截肢率更高（优势比+2.7，95%置信区间1.2至6.2）。手术时行筋膜切开术与截肢率降低相关。
结论
钝性损伤和合并骨折会增加截肢风险。术后应适当监测骨筋膜室压力。即使没有骨筋膜室综合征的证据，在血管修复时也可考虑行筋膜切开术。
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