Johnson M, Ford M, Johansen K
Department of Surgery, Harborview Medical Center, University of Washington School of Medicine, Seattle.
Arch Surg. 1993 Sep;128(9):971-4; discussion 974-5. doi: 10.1001/archsurg.1993.01420210031004.
To determine the relationship between patency of radial or ulnar artery repair and later hand symptoms.
Call-back survey.
Urban trauma center.
Thirty-two subjects with wrist artery lacerations undergoing 26 arterial repairs and six artery ligations during an 8-year period.
Directed history and hand examination (palpation of wrist pulses, Doppler Allen test, and Doppler interrogation of palmar arch and digital vessels).
History of hand claudication, weakness, or cold sensitivity or paresthesias and patency of wrist arteries.
Twelve (46%) of 26 wrist artery repairs were patent. There was no evident benefit of optical magnification or specialization in hand or vascular surgery. No subjects had hand claudication; there was a 50% incidence of hand weakness and a 12% incidence of cold sensitivity independent of patency of the damaged wrist artery and present only in subjects with associated nerve injury. Professional charges for wrist artery repair were threefold to fourfold higher than those for wrist artery ligation.
Consonant with prior reports, patency following repair of radial or ulnar artery laceration does not exceed 50%. Later hand symptoms relate to nerve or tendon damage, not to arterial patency. In the absence of acute hand ischemia, simple ligation of a lacerated radial or ulnar artery is safe and cost-effective.
确定桡动脉或尺动脉修复的通畅情况与后期手部症状之间的关系。
回访调查。
城市创伤中心。
32例腕部动脉撕裂伤患者，在8年期间接受了26次动脉修复和6次动脉结扎。
针对性的病史询问和手部检查（触诊腕部脉搏、多普勒艾伦试验以及对掌弓和指血管进行多普勒检查）。
手部间歇性跛行、无力、冷敏感或感觉异常的病史以及腕部动脉的通畅情况。
26例腕部动脉修复中有12例（46%）通畅。在手部或血管外科手术中，光学放大或专业化并无明显益处。没有患者出现手部间歇性跛行；手部无力的发生率为50%，冷敏感的发生率为12%，与受损腕部动脉的通畅情况无关，且仅出现在伴有相关神经损伤的患者中。腕部动脉修复的专业费用比腕部动脉结扎高三至四倍。
与先前的报告一致，桡动脉或尺动脉撕裂伤修复后的通畅率不超过50%。后期手部症状与神经或肌腱损伤有关，而非动脉通畅情况。在无急性手部缺血的情况下，单纯结扎撕裂的桡动脉或尺动脉是安全且具有成本效益的。
