van Wijngaarden M, Omert L, Rodriguez A, Smith T R
Shock Trauma Center, Maryland Institute for Emergency Medical Services Systems, Baltimore 21201-1595.
Surg Gynecol Obstet. 1993 Jul;177(1):41-8.
During a seven and one-half year period from 1984 to 1991, 106 patients admitted to a Level I trauma center had blunt vascular injury to the extremities. This subset of patients was analyzed with respect to mechanism of injury, associated injuries, method of repair, morbidity and mortality. Twenty patients sustained vascular injuries of the upper limb. Eighty percent of the patients (16 patients) underwent primary vascular repairs, 15 percent had primary amputations and 5 percent (one patient) were observed. Eighty-eight percent (14 of 16 repairs) of the vascular repairs demonstrated excellent neurologic function postoperatively. Eighty-six patients had arterial injuries of the lower extremity. Forty-eight percent (41 patients) of the injured legs were amputated, 41 percent (35 patients) underwent vascular repairs, 6 percent (five patients) underwent ligation of the primary vessel with no amputation and 24 percent (21 patients) underwent no surgical procedure. Sixty-two percent of the 37 patients (23 patients) with popliteal injuries required amputation and 57 percent (21 patients) underwent vascular repair. The overall mortality rate was 11 percent--zero percent for injuries to the upper limb and 14 percent for injuries to the lower limb.
在1984年至1991年的七年半时间里，106名入住一级创伤中心的患者发生了四肢钝性血管损伤。对这组患者的损伤机制、相关损伤、修复方法、发病率和死亡率进行了分析。20名患者发生上肢血管损伤。80%的患者（16例）接受了一期血管修复，15%的患者进行了一期截肢，5%的患者（1例）进行了观察。88%（16例修复中的14例）的血管修复术后神经功能良好。86名患者发生下肢动脉损伤。48%（41例）的受伤下肢被截肢，41%（35例）接受了血管修复，6%（5例）在未截肢的情况下对主要血管进行了结扎，24%（21例）未接受手术治疗。37例腘窝损伤患者中有62%（23例）需要截肢，57%（21例）接受了血管修复。总体死亡率为11%——上肢损伤为0%，下肢损伤为14%。
