Subclavian vascular injuries
Subclavian vascular injuries
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锁骨下血管损伤
DOI：
10.1002/bjs.1800741114
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发表时间：
1987
期刊：
影响因子：
--
通讯作者：
Dr D. Dernetriades
中科院分区：
文献类型：
--
作者：
D. Demetriades;B. Rabinowitz;A. Pezikis;J. Franklin;G. Palexas;Dr D. Dernetriades
该研究包括228名锁骨下血管穿透性损伤患者。仅静脉受累者占44%，仅动脉受累者占39%，两条血管受累者占17%，大多数（61%）患者未能活着到达医院，接受手术者的死亡率为15.5%（总死亡率为66%）。静脉损伤的总死亡率明显高于动脉损伤（P<0.01），可能与空气栓塞的危险并发症有关。体格检查对这些损伤的诊断是可靠的，不需要急诊血管造影。锁骨切口是首选入路。94%的动脉损伤患者进行了修复。静脉损伤60%采用缝合，40%采用结扎，建议选择性保守治疗。
This study comprises 228 patients with penetrating injuries of the subclavian vessels. The vein alone was involved in 44 per cent, the artery alone in 39 per cent, and both vessels in 17 per cent. The majority of the victims (61 percent) did not reach the hospital alive, and in those who were operated on the mortality was 15·5 per cent (overall mortality 66 percent). The overall mortality of venous injuries was significantly higher than the arterial ones (P<0·01), probably because of the dangerous complication of air embolism. Physical examination is reliable in the diagnosis of these injuries and there is no need for an emergency angiogram. The clavicular incision was the preferred approach. Repair was performed in 94 per cent of those with arterial injury. Vein injuries were treated by suture in 60 per cent and ligation in 40 per cent. A selective conservative approach is advised.