Radonić V, Barić D, Giunio L, Bill B, Kovacević H, Sapunar D
Department of Surgery, Clinical Hospital, Split, Croatia.
Cardiovasc Surg. 1997 Dec;5(6):641-7. doi: 10.1016/s0967-2109(97)00083-5.
During the war in Croatia (from May 1991 to December 1995), 67 patients with war injuries of the femoral vein and/or artery were treated at the Surgical Clinic of Split Clinical Hospital. All the wounded were admitted directly from the battlefield or from front-line hospitals. There were five women and 62 men with a median age of 29 (range 15-54) years. There were 70 arterial (28 isolated) and 49 venous injuries (six isolated). Forty-six arterial injuries were repaired by reverse vein graft. Four proximal profound femoral arteries were reconstructed. Major venous injuries were repaired, 11 by compilation autogenous vein graft. No synthetic grafts were used. Repair of veins with large defects using compilation saphenous vein grafts gave good results. Six profound femoral veins and two superficial femoral veins were ligated. Vein ligation should be avoided unless another life-threatening injury demands priority. Twenty-one patients required open prophylactic fasciotomy. Two patients died (3%) and three ultimately underwent amputation (5%). Intermittent hyperbaric oxygen therapy was given to 18 heavily wounded patients with beneficial effect. The results support an immediate and coordinated approach to femoral vascular trauma with repair of arterial and venous injuries.
在克罗地亚战争期间（1991年5月至1995年12月），斯普利特临床医院外科诊所治疗了67例股静脉和/或动脉战伤患者。所有伤员均直接从战场或前线医院收治。其中有5名女性和62名男性，中位年龄为29岁（范围15 - 54岁）。有70处动脉损伤（28处为孤立损伤）和49处静脉损伤（6处为孤立损伤）。46处动脉损伤通过静脉逆行移植修复。4条股深动脉近端进行了重建。主要静脉损伤进行了修复，11例采用自体静脉移植修复。未使用人工合成移植物。采用大隐静脉移植修复大静脉缺损效果良好。6条股深静脉和2条股浅静脉进行了结扎。除非有其他危及生命的损伤需要优先处理，否则应避免静脉结扎。21例患者需要进行预防性切开减压术。2例患者死亡（3%），3例最终接受了截肢手术（5%）。18例重伤患者接受了间歇性高压氧治疗，效果良好。这些结果支持对股血管创伤采取立即且协调一致的治疗方法，包括修复动脉和静脉损伤。
