Abdominal vascular trauma.
Abdominal vascular trauma.
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DOI：
10.1136/tsaco-2016-000015
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发表时间：
2016-01-01
影响因子：
2
通讯作者：
Coimbra, Raul
中科院分区：
文献类型：
--
作者：
Kobayashi, Leslie M;Costantini, Todd W;Coimbra, Raul
腹部血管创伤，主要是由于穿透机制，是罕见的。然而，当它发生时，它可能是相当致命的，死亡率从20%到60%不等。早期死亡率的增加与休克、酸中毒、体温过低、凝血障碍、游离性腹腔内出血和美国创伤外科协会器官损伤量表分级的高级相关。这些患者通常在极端情况下到达医疗中心，需要快速手术控制出血和积极复苏，包括大量输血方案。生存的最重要因素是手术控制出血和恢复腹腔内容物和下肢的适当灌注。这些手术方法和确定性血管修复技术可能相当具有挑战性，特别是对于没有经验的外科医生。本文旨在描述最常见的腹部血管损伤，其表现，结果，以及控制和修复此类损伤的外科技术。
Abdominal vascular trauma, primarily due to penetrating mechanisms, is uncommon. However, when it does occur, it can be quite lethal, with mortality ranging from 20% to 60%. Increased early mortality has been associated with shock, acidosis, hypothermia, coagulopathy, free intraperitoneal bleeding and advanced American Association for the Surgery of Trauma Organ Injury Scale grade. These patients often arrive at medical centers in extremis and require rapid surgical control of bleeding and aggressive resuscitation including massive transfusion protocols. The most important factor in survival is surgical control of hemorrhage and restoration of appropriate perfusion to the abdominal contents and lower extremities. These surgical approaches and the techniques of definitive vascular repair can be quite challenging, particularly to the inexperienced surgeon. This review hopes to describe the most common abdominal vascular injuries, their presentation, outcomes, and surgical techniques to control and repair such injuries.