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일개 응급센터에 내원한 외상성 혈관손상 환자의 임상적 특성
박용면 ( Yong Myeon Park ),염석란 ( Seok Ran Yeom ),정진우 ( Jin Woo Jeong ),한상균 ( Sang Kyun Han ),조석주 ( Suck Ju Cho ),류지호 ( Ji Ho Ryu ),김용인 ( Yong In Kim ),정성운 ( Sung Woon Chung ) 대한외상학회 2009 大韓外傷學會誌 Vol.22 No.1
Purpose: The mortality and the amputation rates due to vascular trauma remain high despite advanced vascular surgical techniques and supportive management. The clinical features of patients with vascular trauma have not been well studied in the Korean population. The aim of this study was to analyze the clinical characteristics of patients with vascular trauma and to develop a database and guidelines for improving the outcomes of treatment. Methods: The medical records of 37 patients with traumatic vascular injuries who had visited in an emergency center between January 2002 and December 2006 were retrospectively reviewed and statistically analyzed. Results: The mean age was 37.8 years, and the male-to-female ratio was 5.2:1. The mechanism of vascular trauma was penetrating in 18 patients and blunt in 19 patients. Upper extremities were most frequently injured (39.4%). The treatment methods were primary repair in 21 patients, exploratory laparotomies in 7, radiological interventions in 3, resections and graft interpositions of the pseudoaneurysm in 3, observations in 3 and a bypass graft in 1. Four out of the 37 patients died, and three of these who died had injuried abdominal vessels. Twenty-five of the patients recovered completely, four expired, seven had neuropathy in the course of treate-ment, one had his limb amputated, and one experienced wound necrosis. Conclusion: Peripheral vessel injuries are commonly accompanied by nerve, muscle, or tendon injuries. Patients without associated fractures or compartment syndrome had good prognosis. Although the time intervals from hospital arrival to definite treatment were the shortest among patients with blunt abdominal vascular injuries, three expired. Therefore, we offer a `critical pathway` to improve the outcomes of patients with blunt abdominal vascular injury. (J Korean Soc Traumatol 2009;22:5-11)
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