由于重创伤造成的关节下动脉破裂:一个病例报告
Suyeong Hwang1, Gun Woo Kim1, Sung Hoon Cho1
1Division of Trauma and Critical Care, Department of Surgery, Trauma Center, Kyungpook National University Hospital, School of Medicine, Kyungpook National University, Daegu, Republic of Korea.
Medicine
|July 12, 2024
概括
形创伤可能导致罕见但严重的关节底动脉损伤. 在危急病例中,内血管栓塞优先考虑生命而不是肢体救援,导致患者尽管截肢仍能存活.
科学领域:
- 创伤外科 手术 创伤外科
- 血管外科 血管外科
- 干预性放射学 干预性放射学
背景情况:
- 关节下动脉损伤从重的创伤是罕见的,但携带死亡的高风险.
- 潜在的结果包括大规模出血和四肢缺血,通常需要开放性修复.
- 对危急不稳定的患者来说,优先考虑拯救生命的干预措施至关重要.
研究的目的:
- 报告一个严重的关节下动脉损伤的病例,其后是重的创伤.
- 要突出在血液动力学不稳定的患者的管理挑战和决策过程.
- 强调内血管技术在管理危及生命的血管损伤中的作用.
主要方法:
- 一名21岁的男性遭受了重创伤,并接受了计算机断层扫描 (CT) 和血管造影.
- 诊断包括右损伤,血胸病和右第八肋间动脉损伤.
- 进行了侧侧胸切除术,揭示了可疑的下关节动脉损伤,随后是右下关节动脉的内血管栓塞.
主要成果:
- 患者呈现出血胸和肢体缺血的迹象.
- 尽管大量输血,但生命体征仍然不稳定,右臂变硬.
- 右下关节动脉的内血管栓塞成功控制了出血.
- 患者在第12天接受了跨度截肢,在经历了多器官衰竭后幸存下来.
结论:
- 当救生措施至关重要时,肢体救援并不总是可行的.
- 在复杂创伤病例中,快速的外科决策对于患者的生存至关重要.
- 内血管方法为血管创伤中的拯救生命的干预提供了一个不那么侵入性的选择.
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