Sfeir R E, Khoury G S, Kenaan M K
Department of Surgery, American University of Beirut Medical Center, Lebanon.
Cardiovasc Surg. 1995 Dec;3(6):653-7. doi: 10.1016/0967-2109(96)82865-1.
The authors' experience with 386 patients who were operated on for vascular injuries to the lower extremities is reviewed. Of these, 118 had popliteal injuries, 252 had femoral injuries and 16 had tibial injuries. The overall mortality rate was 2.33% with no mortality in the popliteal and tibial injuries group whereas there were nine deaths in the femoral injuries group. The overall amputation rate was 5.95%, with 3.17% amputation rate for the femoral injuries group versus 11.86% for the popliteal injuries group and 6.25% for the tibial injuries group. Delay in repair (more than 6 h from injury), associated femoral fractures and shocked condition on admission led to increased amputation rate. Prompt surgical repair, arterial as well as venous repair for popliteal and femoral injuries especially if femoral fracture is present, external skeletal fixation and/or traction, and fasciotomy when necessary led to improved limb salvage.
回顾了作者对386例接受下肢血管损伤手术患者的经验。其中，118例为腘窝损伤，252例为股部损伤，16例为胫部损伤。总体死亡率为2.33%，腘窝和胫部损伤组无死亡病例，而股部损伤组有9例死亡。总体截肢率为5.95%，股部损伤组截肢率为3.17%，腘窝损伤组为11.86%，胫部损伤组为6.25%。修复延迟（受伤后超过6小时）、合并股骨干骨折以及入院时休克状态导致截肢率增加。对于腘窝和股部损伤，尤其是存在股骨干骨折时，及时进行手术修复、动脉和静脉修复，必要时进行外骨骼固定和/或牵引以及筋膜切开术，可提高肢体挽救率。
