외상성 동맥손상 환자의 임상양상 변화

초록

Purpose: As traffic accidents and invasive vascular procedures are increasing these days, so are vascular trauma, either blunt or penetrating. Therefore, we investigated the changes in the clinical status of vascular trauma over the last 10 years. Method: We retrospectively reviewed the medical records of 121 patients who were admitted and operated on at Korea University Hospital due to traumatic arterial injuries from 1990 to 1999. We divided these patients by period into two groups: Era 1 (1990–1994) and Era 2 (1995–1999). The former group included 51 patients, and the latter 70. Age distribution, causes of injury, location, degree of injury, amputation rate, mortality rate, and operation methods between these two groups were compared. Result: The most common cause of arterial injury was blunt trauma by traffic accident in Era 1 and injury by broken glass in Era 2. Iatrogenic injury cases increased (from 3.9% in Era 1 to 10% in Era 2), and industrial injuries also increased. The two groups showed a similar distribution of degree and location of injuries. The amputation rate in cases of vascular trauma of the lower extremities correlated with combined fracture in both groups (p < 0.05). The amputation rate was 35.5% in Era 1 and 23.5% in Era 2. The mortality rate was 15.7% in Era 1 and 12.9% in Era 2 (p > 0.05). Each group presented a statistically significant correlation between the location of injury and mortality (p < 0.05). Abdominal injury was related to a high mortality rate (63.2%). Conclusion: The latter period (Era 2) showed an increased iatrogenic injury rate compared to the former. The amputation rate increased when combined with fracture in both groups, but the mortality rate did not significantly change between the two groups.

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