Analysis of vascular trauma in terror-related civilian attacks within South-Eastern Turkey
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Dosyalar
Tarih
2016
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Cilt Başlığı
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Erişim Hakkı
info:eu-repo/semantics/openAccess
Özet
Türkiye'nin Güneydoğusu'nda meydana gelen teröre bağlı vasküler yaralanmalar ve mor-- talite göstergelerini incelemek. Gereç ve Yöntemler. Ocak 2012--Ağustos 2015 arasında teröre bağlı vasküler yaralanması olan 88 hasta (82 erkek, yaş 24418.1) bu retrospektif çalışmaya alındı. Travmatik amputasyon, yaygın doku kaybı, ciddi sinir hasarina bağlı amputasyon ve baş yaralanması olan hastalar çalışmaya alınmadı. Hastalar yaralanmanın ciddiyeti ve mekanizması, travma lokalizasyonu ve cerrahi tedavi şekillerine göre değerlendirildi. Bulgular: Kırkaltı (%52.3) hastada alt ekstremite, 19 (%21.6) hastada üst ekstremite, 13 (%14.8) hastada alt ve üst ekstremitede vasküler yaralanma vardı. Ayrıca boyun (n=3; %3.4), toraks (n=2; %2.3), abdomino--pelvik (n=5; %5.7) yaralanmalar da vardı. Yaralanmaların 23'ü (%26.1) mermi, 54'ü (%61.4) şarapnel, 11'i (%12.5) patlama sebebiyle meydana gelmişti. Hataların 38'i (%43.2) hastaneye geldiklerinde hipovolemik şoktaydı. Kırk (%45.5) hastada izole arter, 42 (%47.7) hastada arter ve ven, (%6.8) hastada sadece ven yaralanması vardı. Yirmisekiz (%31.8) hastada otojen greft, 10 (%11.4) hastada sentetik greft kullanıldı. Onsekiz (%20.5) hastada vasküler ligasyon yapıldı. Yedi (%8) hastada postoepratif akut böbrek hasarı gelişti. Yirmisekiz (%31.8) hastada yara enfeksiyonu gelişti. Çalışmamızda erken dönem mortalite oranı %18.2 (16 hasta)'dir. Hipovolemik şok (p<0.0001), akut böbrek yetmezliği (p=0.002) ve masif kan transfüzyonu (p=0.007) mortalite prediktörleridir. Sonuç: Teröre bağlı bağlı vasküler yaralanmalarda multi--disipliner yaklaşımla hipovolemik şok tedavi edilmeli, akut renal yetmezlik engellenmeli ve acil kompleks vasküler cerrahi girişimler planlanmalıdır.
To evaluate the results of terror related vascular injuries and predictors of mor-- tality caused by these injuries in South--Eastern Turkey. Material and Methods: Eighty--eight patients (82 men, 24.4 8.1 years) who had vasculary trauma in terrorist attacks between ]anuary 2012--August 2015 in South--Eastern Turkey included in this retrospective study. Patients with traumatic amputations, ex-- tensive tissue losses, amputations after severe nerve damage and head injuries were excluded. Study pa-- tients were analyzed according to the mechanism and severity of injury, location of trauma, and surgical treatment options. Results: Forty-six (52.3%) patients had lower limb, 19 (21 .6%) patients had upper limb, 13 (14.8%) patients had both upper and lower limb vascular injuries. Other vascular injuries involved neck (n=3; 3.4%), thorax (n=2; 2.3%), abdomino--pelvic (n=5; 5.7%) locations. Twenty--three (26.1%) of them were caused by bullets, 54 (61.4%) by shrapnel and 11 (12.5%) by bombs and explosions. Thirty--eight (43.2%) of these patients were in hypovolemic shock at admittance. Forty patients (45.5%) had isolated arterial, 42 (47.7%) patients had both artery and vein, (6.8%) patients had isolated vein injuries. Auto-- genous grafts were used in 28 (31.8%) patients, and synthetic grafts were used in 10 (11.4%) patients. Vas-- cular ligations were performed in 18 (20.5%) patients. Seven (8%) patients had acute renal injury and 28 (31.8%) patients had wound infections postoperatively. Overall in--hospital mortality rate was 18.2% (16 patients). Hypovolemic shock (p<0.0001), acute renal failure (p=0.002) and massive blood transfusion (p=0.007) were the main predictors of mortality. Conclusion: Vascular injuries in terror--related trauma victims require multidisiplinary urgent treatment of hypovolemic shock, preventive measures to avoid acute renal failure and immediate complex vascular surgery.
To evaluate the results of terror related vascular injuries and predictors of mor-- tality caused by these injuries in South--Eastern Turkey. Material and Methods: Eighty--eight patients (82 men, 24.4 8.1 years) who had vasculary trauma in terrorist attacks between ]anuary 2012--August 2015 in South--Eastern Turkey included in this retrospective study. Patients with traumatic amputations, ex-- tensive tissue losses, amputations after severe nerve damage and head injuries were excluded. Study pa-- tients were analyzed according to the mechanism and severity of injury, location of trauma, and surgical treatment options. Results: Forty-six (52.3%) patients had lower limb, 19 (21 .6%) patients had upper limb, 13 (14.8%) patients had both upper and lower limb vascular injuries. Other vascular injuries involved neck (n=3; 3.4%), thorax (n=2; 2.3%), abdomino--pelvic (n=5; 5.7%) locations. Twenty--three (26.1%) of them were caused by bullets, 54 (61.4%) by shrapnel and 11 (12.5%) by bombs and explosions. Thirty--eight (43.2%) of these patients were in hypovolemic shock at admittance. Forty patients (45.5%) had isolated arterial, 42 (47.7%) patients had both artery and vein, (6.8%) patients had isolated vein injuries. Auto-- genous grafts were used in 28 (31.8%) patients, and synthetic grafts were used in 10 (11.4%) patients. Vas-- cular ligations were performed in 18 (20.5%) patients. Seven (8%) patients had acute renal injury and 28 (31.8%) patients had wound infections postoperatively. Overall in--hospital mortality rate was 18.2% (16 patients). Hypovolemic shock (p<0.0001), acute renal failure (p=0.002) and massive blood transfusion (p=0.007) were the main predictors of mortality. Conclusion: Vascular injuries in terror--related trauma victims require multidisiplinary urgent treatment of hypovolemic shock, preventive measures to avoid acute renal failure and immediate complex vascular surgery.
Açıklama
Anahtar Kelimeler
Cerrahi
Kaynak
Damar Cerrahi Dergisi
WoS Q Değeri
Scopus Q Değeri
Cilt
25
Sayı
3
