Cornwell E E, Kennedy F, Ayad I A, Berne T V, Velmahos G, Asensio J, Demetriades D
Department of Surgery, University of Southern California School of Medicine, USA.
Arch Surg. 1996 Sep;131(9):949-52; discussion 952-3. doi: 10.1001/archsurg.1996.01430210047009.
To evaluate the contribution of aortography in the management of stable patients with transmediastinal gunshot wounds.
Retrospective review of clinical records.
Level I urban trauma center.
Forty-three patients with aortic or esophageal gunshot injuries.
Patients who were stable after initial resuscitation underwent aortography followed by esophagography.
Hemodynamic status on admission, time devoted to diagnostic workup, surgical (or autopsy) findings, morbidity, and mortality.
There were 24 esophageal injuries and 20 aortic injuries. Patients with aortic injuries were less often stable for aortography (10% vs 42%; P = .02), and fewer of them survived (15% vs 58%; P = .01). In no patient was the aortic injury initially detected by aortography. Stable patients with esophageal injuries experienced an average 11-hour interval between injury and surgery (nearly 3 hours attributable to aortography).
Esophageal evaluation should precede aortography in the workup of stable patients with transmediastinal gunshot wounds.
评估主动脉造影在稳定的经纵隔枪伤患者治疗中的作用。
对临床记录进行回顾性分析。
一级城市创伤中心。
43例主动脉或食管枪伤患者。
初始复苏后病情稳定的患者先接受主动脉造影，然后进行食管造影。
入院时的血流动力学状态、诊断检查所用时间、手术（或尸检）结果、发病率和死亡率。
有24例食管损伤和20例主动脉损伤。主动脉损伤患者中能接受主动脉造影的稳定患者较少（10%对42%；P = 0.02），存活的患者也较少（15%对58%；P = 0.01）。没有患者的主动脉损伤最初是通过主动脉造影检测到的。食管损伤的稳定患者受伤至手术的平均间隔时间为11小时（近3小时归因于主动脉造影）。
在对稳定的经纵隔枪伤患者进行检查时，食管评估应先于主动脉造影。
