在枪伤中管理周围血管损伤:一个外科的角度
Deidré Ek McPherson1, Tristan Rensburg1, Andrew Nicol1
1Division of General Surgery, Trauma Surgery, Groote Schuur Hospital and University of Cape Town, Anzio Road, Observatory, Cape Town, 7925, South Africa.
Injury
|October 31, 2025
概括
枪伤 (GSWs) 造成的与枪支相关的血管创伤是开普敦的一个主要问题. 及时管理可以改善肢体和患者的存活率,但长期并发症仍然存在.
科学领域:
- 血管外科 血管外科
- 创伤护理 创伤护理
- 公共卫生 公共卫生
背景情况:
- 与枪支相关的血管创伤,特别是来自枪伤 (GSWs),是南非开普敦的一个重大公共卫生问题.
- 肢体动脉损伤是枪伤的常见后果,需要专门的创伤中心管理.
- 格罗特·舒尔医院的1级创伤中心每月管理大约1000名创伤患者,重点是穿透性伤害.
研究的目的:
- 审查Groote Schuur医院创伤中心在管理GSWs造成的四肢动脉损伤方面的经验.
- 要突出机构对血管创伤的方法,强调救命干预, perfusion 恢复和肢体保护.
- 讨论用于管理这些复杂伤害的诊断和治疗方法.
主要方法:
- 审查临床经验在管理由于GSWs的四肢动脉损伤.
- 应用高级创伤生命支持 (ATLS) 原则.
- 使用诊断工具,包括脚臂指数 (ABI),动脉压指数 (API),双重超声波和计算机断层扫描血管学 (CTA).
- 采用开放式手术修复和内血管技术,与切术一起用于隔间综合征的预防.
主要成果:
- 臂和大腿动脉最常受到影响是穿透 extremity 血管创伤.
- 患者管理以血液动力学状态和肢体活力为指导.
- 虽然开放式手术是标准的,但内血管方法越来越多地被使用.
- 延迟护理显著导致肢体损失和死亡率.
结论:
- 及时管理与枪支有关的血管创伤可以实现患者和肢体的生存.
- 长期并发症,如移植失败,慢性疼痛和心理影响是常见的.
- 系统性投资于综合创伤护理,从医院前到康复,对于改善结果至关重要.
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