Wilson R F
Department of Surgery, Detroit Receiving Hospital, Michigan.
Crit Care Clin. 1994 Jul;10(3):567-93.
Patients with PAD tend to be much older physiologically than patients of the same chronologic age who do not have vascular disease. In addition, patients with vascular disease in one system tend to have vascular disease in other areas of the body, especially in the vessels supplying the heart and brain. Many also have pre-existing pulmonary and renal dysfunction. Even if trauma does not involve any diseased vessels, the hypotension that often occurs with major injuries may cause thrombosis of vessels that have a critical degree of stenosis. If a diseased vessel is injured, direct reconstruction may be difficult or impossible and a bypass may have to be performed. If this is not feasible in a severely injured lower extremity, early amputation may be the safest option. Even if the initial trauma is handled very well, patients with vascular disease tend to have an increased incidence of complications and death, and such patients require careful intensive care unit monitoring for at least 2 to 3 days.
患有外周动脉疾病（PAD）的患者在生理上往往比同龄但无血管疾病的患者年长许多。此外，一个系统患有血管疾病的患者往往身体其他部位也有血管疾病，尤其是供应心脏和大脑的血管。许多患者还存在先前就有的肺和肾功能障碍。即使创伤未累及任何病变血管，重大损伤常伴有的低血压也可能导致已有临界狭窄程度的血管发生血栓形成。如果病变血管受损，直接重建可能困难或无法进行，可能不得不进行旁路手术。如果在严重受伤的下肢无法做到这一点，早期截肢可能是最安全的选择。即使初始创伤处理得非常好，患有血管疾病的患者并发症和死亡的发生率往往也会增加，这类患者需要在重症监护病房至少进行2至3天的密切监测。
