Gill S S, Eggleston F C, Singh C M, Abraham K A, Kumar S, Lobo L H
J Trauma. 1976 Oct;16(10):766-72. doi: 10.1097/00005373-197610000-00002.
Fifty-eight patients with arterial injuries of the extremities were treated during the past 8 years. Fifty-one had acute injuries and seven had nonacute injuries. Blunt trauma or shotgun wounds caused 74% of the injuries, and 55% were associated with skeletal trauma. All the acute injuries endangered the limb; the average ischemic time was 8.5 hours. Brachial, popliteal, and superficial femoral arterial injuries were seen most frequently. Repair was accomplished with autogenous saphenous vein grafts in 47% and end-to-end anastomosis in 41%. Six patients died, four due to injuries of other organs. The most alarming complication of arterial repair was secondary hemorrhage which occurred in three patients and was caused by local infection. Six patients (13.3% required amputations; the highest number (three) after injuries of the popliteal artery. The injuries leading to amputations had associated prolonged ischemia, severity of injury, and associated venous, soft tissue, and skeletal injury. The nonacute injuries were in the form of false aneurysms, pulsating hematomas, AV fistula, and delayed bleeding. These were easily managed without any significant complication.
在过去8年中，共治疗了58例四肢动脉损伤患者。其中51例为急性损伤，7例为非急性损伤。钝性创伤或猎枪伤导致了74%的损伤，55%的损伤伴有骨骼创伤。所有急性损伤均危及肢体；平均缺血时间为8.5小时。最常见的损伤部位是肱动脉、腘动脉和股浅动脉。47%的患者采用自体大隐静脉移植进行修复，41%的患者采用端端吻合。6例患者死亡，4例死于其他器官损伤。动脉修复最令人担忧的并发症是继发性出血，3例患者发生了继发性出血，原因是局部感染。6例患者（13.3%）需要截肢；腘动脉损伤后截肢的患者最多（3例）。导致截肢的损伤伴有长时间缺血、损伤严重程度以及相关的静脉、软组织和骨骼损伤。非急性损伤表现为假性动脉瘤、搏动性血肿、动静脉瘘和延迟性出血。这些损伤易于处理，且无任何严重并发症。
