Degiannis E, Velmahos G C, Florizoone M G, Levy R D, Ross J, Saadia R
Department of Surgery, Baragwanath Hospital, University of the Witwatersrand, Johannesburg, Republic of South Africa.
Ann R Coll Surg Engl. 1994 Sep;76(5):307-10.
This study describes the management of 43 patients with penetrating injury of the popliteal artery. Of these patients, 33 (76.5%) had bullet wounds, four patients (9.5%) pellet wounds and 6 (14%) knife wounds. Patients with 'hard' signs of arterial injury underwent exploration without preoperative angiograms. There were no negative explorations. Patients with only 'soft' signs of arterial injury underwent preoperative angiograms. Of this group, 75% had positive angiograms and underwent exploration. There were no false-positive or false-negative preoperative angiograms in the group of patients with 'soft' signs in this study. Definitive orthopaedic management of associated fractures followed vascular reconstruction. There was no difference in the short-term patency of autologous saphenous vein graft as against PTFE grafts. Fasciotomy was performed on patients who had arterial and venous injury or presented late. Overall amputation rate was 14% and for bullet injuries 18%.
本研究描述了43例腘动脉穿透伤患者的治疗情况。在这些患者中，33例（76.5%）为枪伤，4例（9.5%）为弹片伤，6例（14%）为刀伤。有动脉损伤“硬”体征的患者在未进行术前血管造影的情况下接受了探查。无探查阴性情况。仅有动脉损伤“软”体征的患者接受了术前血管造影。在这组患者中，75%血管造影呈阳性并接受了探查。本研究中，有“软”体征的患者组术前血管造影无假阳性或假阴性情况。相关骨折的确定性骨科治疗在血管重建之后进行。自体大隐静脉移植与聚四氟乙烯移植的短期通畅率无差异。对有动脉和静脉损伤或就诊较晚的患者进行了筋膜切开术。总体截肢率为14%，枪伤患者的截肢率为18%。
