儿童钝性肱动脉损伤后无脉搏灌注手保守入路是安全的。

IF 0.5 Q4 PERIPHERAL VASCULAR DISEASE
Ahmad R Naga, Ali A Elemam, Nagib A Elaskary, Ashraf E Elsharkawy, Hassan Lotfy
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引用次数: 0

摘要

钝性创伤的肱动脉(BA)在儿童年龄往往与神经和矫形损伤。急性缺血性手需要立即探索,但管理无脉搏的手在肘部创伤是有争议的。本研究评估了保守治疗在儿童无威胁手钝性BA损伤中的作用。回顾性研究了11例手部无温脉搏的钝性创伤患儿。平均随访2.5±0.9年,所有病例均行全面临床检查和双相扫描评估治疗效果。在随访期结束时,所有受试者的手部血液循环良好,手腕脉搏完整。双工扫描显示间置移植物通畅,一例动脉瘤扩张。患侧与健康前臂的平均腕部收缩速度峰值分别为62±0.82 cm/s和68±0.57 cm/s,差异无统计学意义(p值= 0.14)。钝性BA创伤和手无温脉的患者可以通过保守治疗安全管理,对于48小时后仍未恢复脉搏的患者,可留待手术探查。双工超声可以安全地验证手术修复的通畅性,并可用于监测发现未来的并发症。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Conservative Approach is Safe for Perfused-Pulseless Hands Following Blunt Brachial Artery Injury in Children.

Blunt trauma of the brachial artery (BA) in pediatric age is often associated with neurological and orthopaedic injuries. Acute ischemic hands warrant immediate exploration, but the management of warm-pulseless hands following elbow trauma is controversial. This study evaluates the role of conservative treatment of blunt BA injuries in children with non-threatened hands. Eleven children with blunt trauma onto the BA having warm-pulseless hands were studied retrospectively. After a mean follow-up period of 2.5 ± 0.9 years, all cases had thorough clinical examination and duplex scan to assess the treatment outcomes. At the end of follow-up period, all subjects had well-perfused hands with intact wrist pulses. The duplex scan revealed those who had interposition grafts to be patent and one case had an aneurysmal dilatation. There was no statistical significance difference between affected and healthy forearms regarding the mean peak systolic velocity at the wrist, affected side was 62 ± 0.82 cm/s versus 68 ± 0.57 cm/s for opposite side ( p -value = 0.14). Patients with blunt BA trauma and warm-pulseless hands could be managed safely with conservative treatment, leaving surgical exploration for those who did not regain pulses after 48 hours. Duplex ultrasound can safely verify the patency of surgical repair and can be used for surveillance to detect future complications.

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来源期刊
International Journal of Angiology
International Journal of Angiology PERIPHERAL VASCULAR DISEASE-
CiteScore
1.30
自引率
16.70%
发文量
57
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