国际指南与中国共识视角下的血管创伤救治：2025版ESVS指南与中国专家共识的整合解读

Vascular trauma management from the perspectives of international guidelines and Chinese consensus: an integrated interpretation of the 2025 ESVS guidelines and the Chinese expert consensus

摘要:

血管创伤是创伤外科和血管外科领域中致死致残率较高的急危重症，其诊治策略随着介入技术、围手术期管理理念及多学科协作模式的发展不断更新。2025年欧洲血管外科学会（ESVS）首次发布《血管创伤管理临床实践指南》。该指南作为国际血管外科领域的权威循证医学文件，为全球血管创伤的标准化诊疗提供了关键依据。与此同时，中国全军血管外科学组等机构基于我国战创伤救治经验与研究成果，发布了《血管战创伤救治专家共识》，该共识聚焦于战场及灾难等特殊场景，在分级救治体系、火线急救止血技术、血管损伤控制性手术等重点领域，提出了极具中国特色与实践价值的解决方案，是对国际指南的重要补充和细化。本文旨在对中外指南共识进行深度对比、分析与整合，系统梳理其在流行病学、诊断评估、处理原则、各部位损伤管理及术后康复等方面的异同与互补性，以期构建一个融合国际前沿证据与中国实战经验的临床决策框架，从而为国内临床实践提供切实可行的参考。

Abstract:

Vascular trauma represents a group of life-threatening emergencies with high rates of mortality and disability in the fields of trauma surgery and vascular surgery. Its diagnostic and therapeutic strategies have continuously evolved with advances in endovascular techniques, perioperative management concepts, and multidisciplinary collaboration models. In 2025, the European Society for Vascular Surgery (ESVS) released, for the first time, the Clinical Practice Guidelines on the Management of Vascular Trauma. As an authoritative evidence-based document in the field of international vascular surgery, these guidelines provide a critical foundation for the standardized management of vascular trauma worldwide. Meanwhile, based on China's accumulated experience and research achievements in combat-related trauma care, organizations including the Chinese Military Vascular Surgery Group published Chinese expert consensus on the management of vascular combat injuries. This consensus focuses on special scenarios such as battlefield injuries and disaster settings, and proposes solutions with distinct Chinese characteristics and strong practical value in key areas including tiered trauma care systems, frontline hemorrhage control techniques, and damage control surgery for vascular injuries. It serves as an important supplement and refinement to existing international guidelines. The present article aims to conduct an in-depth comparison, analysis, and integration of these two pivotal documents, systematically summarizing their similarities, differences, and complementarities in terms of epidemiology, diagnostic assessment, management principles, region-specific injury management, and postoperative rehabilitation. By integrating international frontier evidence with China's real-world combat trauma experience, this work seeks to construct a pragmatic clinical decision-making framework to provide feasible and applicable guidance for domestic clinical practice.