Progress in the application of temporary vascular shunt in the management of limb vascular injuries
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Diabetic Foot Center,the Air Force Hospital From Eastern Theater of PLA,Nanjing 210002 ,China
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摘要:
下肢大血管损伤是临床常见的危急重症,占所有血管损伤的15%~20%。肢体动脉损伤的处理核心目标是快速止血和恢复外周动脉血流。临时血管分流术(temporary vascular shunting,TVS)作为损伤控制外科(damage control surgery,DCS) 的重要组成部分,通过构建临时性血管分流通路,能够有效维持远端血供,达到损伤控制修复的目标,为后期确定性修复创造有利条件,在救治此类损伤中发挥着关键作用,其价值已在多发伤救治中得到充分验证,其置入与移除时机、技术直接影响血管修复的最终效果及患者预后,及时识别、有效处理并发症是提高救治成功率、改善患者生活质量的关键。文章从TVS技术的历史、有效性、适应证和禁忌证、类型和操作、术后管理和未来发展方向等方面进行全面阐述,以期为肢体血管外伤急救提供新的思路。
Abstract:
Lower extremity major vascular injury is a common critical emergency in clinical practice,accounting for approximately 15% -20% of all vascular injuries. The core goal of managing limb arterial injuries is rapid hemostasis and restoration of peripheral arterial blood flow. Temporary vascular shunting(TVS),as an essential component of damage control surgery(DCS),by establishing a temporary vascular shunt,distal blood supply can be effectively maintained,achieving the objective of damage control and repair. this creates favorable conditions for subsequent definitive repair. TVS plays a key role in the management of such injuries. The timing and technique of insertion and removal directly impact the final outcome of vascular repair and the patient’s prognosis. Timely identification and effective management of complications are key to improving the success rate of treatment and enhancing the patient’ s quality of life. This article provides a comprehensive review of the history,efficacy,indications and contraindications,types and procedures,postoperative management,and future development directions of TVS technology,aiming to offer new insights for emergency care in limb vascular trauma.