血管战创伤救治原则

Management of traumatic vascular injury in war wounds

近年来外军的作战表明,无论是规模化战争还是局部战争,血管战创伤的比例都显著增加。血管战创伤的救治情况在很大程度上决定了战场救护的成功与否,也增加了军队医疗机构对于提升血管战创伤救治能力的紧迫感。对于血管战创伤的诊断、救治,战地救护人员应遵循"快速诊断、快速止血、快速重建血运"原则。当合并有多发伤时,须遵循"血管重建第一"的原则,并且尽可能同时重建动、静脉。目前,传统血管结扎、血管旁路术仍是战时血管外伤救治的主要方式。腔内技术受限于复杂战场环境的限制,未能得到大规模应用。未来,开放与腔内结合可能成为血管战创伤救治的新手段,军事机构和民用科研机构应加强合作,促进新装备、新器械研发,提升血管战创伤救治能力。

In recent years,the combat experience of foreign troops has shown that whether it is a large-scale war or a local war,the proportion of traumatic vascular injury has increased significantly.Treatment of the vascular war trauma largely determines the success of the battlefield rescue,and it also increases the sense of urgency for military medical institutions to improve the ability to treat vascular war injury.For the diagnosis and treatment of traumatic vascular injury,the field medical personnel should follow the principle of"rapid diagnosis,rapid hemostasis,and rapid revascularization".When multiple injuries are combined,the principle of"vascular reconstruction first"should be followed,and arteries and veins should be reconstructed at the same time as possible.At present,traditional vascular ligation and vascular bypass are still the main methods of treatment of vascular trauma in wartime.Endovascular technique is limited by the complexity of the battlefield environment and has not been applied on a large scale.In the future,the combination of open and endovascular surgeries may become new options of treating vascular warfare trauma.Military institutions and civilian scientific research institutions should strengthen cooperation to promote the development of new equipment,and improve the ability to treat traumatic vascular injuries in wartime.