Carotid Artery Injuries Caused by Blunt Trauma
Carotid Artery Injuries Caused by Blunt Trauma
复制标题
钝性创伤引起的颈动脉损伤
作者：
M. Perry;W. Snyder;E. Thal
由钝性创伤引起的颈动脉损伤通常引起血栓形成和迟发性神经功能缺损，并且与高达40%的死亡率相关。在这一系列的17例颈动脉钝伤患者中，3例无症状，10例肢体轻瘫，4例有严重的神经功能缺损。通过动脉造影确定伤口; 15名患者尝试修复，8名成功。所有8例成功修复的患者在手术后均得到改善或正常，但9例未修复的患者中只有2例改善，4例死亡。该系列的死亡率为23%，但在颈动脉手术患者中仅为14%。这一经验表明，修复是安全和有效的患者颈动脉损伤，其中血流持续，只有轻微的神经功能缺损。相反，完全闭塞、严重神经问题和意识改变的患者不太可能通过尝试血运重建得到帮助。
Carotid artery injuries caused by blunt trauma often cause thrombosis and delayed neurologic deficits, and are associated with mortality rates of up to 40%. In this series of 17 patients with blunt trauma of the carotid, three had no symptoms, ten patients had limb paresis and four had severe neurologic deficits. The wounds were identified by arteriography; repair was attempted in 15 patients, and successful in eight. All eight patients with successful repair were improved or normal after surgery, but only two out of nine patients without repair improved, and four died. The mortality rate for the series was 23%, but only 14% in the patients who had carotid surgery. This experience suggests that repair is safe and effective in patients with carotid injuries in whom prograde flow continues and only mild neurologic deficits are present. In contrast, patients with complete occlusion, severe neurologic problems, and altered consciousness are not likely to be helped by attempts at revascularization.