Luetić V, Sosa T, Tonković I, Petrunić M, Cohadzić E, Loncarić L, Romić B
Department of Vascular Surgery, Teaching Faculty, University of Zagreb, Croatia.
Cardiovasc Surg. 1993 Feb;1(1):3-6.
A single-centre experience of military vascular injuries in the recent conflict in Yugoslavia is reviewed. From 1 April to 13 December 1991, 1020 casualties were admitted to the Surgical Clinic at the Teaching Faculty of the University in Zagreb, Croatia. A total of 120 injured blood vessels in 76 patients were treated in the department of vascular surgery. Casualties were transported to the hospital after treatment by forward surgical facilities. The transportation time ranged from 3 to 18 (mean 7) h. The most common injuries were to the popliteal artery (12.5%) and brachial veins (10.0%). After segmental resection, arterial and venous revascularization with saphenous vein graft interposition was the preferred option. Twenty-six fasciotomies were performed because of compartment syndrome. Indications for six amputations included sepsis, deep vein thrombosis and extensive myonecrosis. Concomitant bone fractures were stabilized by an external fixator in 90.4% of cases. Vascular injuries were repaired before orthopaedic stabilization. Completion arteriography was used to delineate concomitant distal lesions.
回顾了在南斯拉夫近期冲突中军事血管损伤的单中心经验。1991年4月1日至12月13日,克罗地亚萨格勒布大学教学医院外科诊所收治了1020名伤员。血管外科共治疗了76例患者的120条受伤血管。伤员在经过前方外科设施治疗后被送往医院。转运时间为3至18小时(平均7小时)。最常见的损伤是腘动脉(12.5%)和肱静脉(10.0%)。节段性切除后,采用大隐静脉移植进行动脉和静脉血管重建是首选方案。因骨筋膜室综合征进行了26次筋膜切开术。6例截肢的指征包括脓毒症、深静脉血栓形成和广泛的肌坏死。90.4%的病例通过外固定器稳定了合并的骨折。在骨科稳定之前修复血管损伤。采用血管造影术来明确合并的远端病变。