怪我後の腹部部部位症候群:認識から予防へ
Zsolt J Balogh1, William Lumsdaine1, Ernest E Moore2
1Department of Traumatology, John Hunter Hospital and University of Newcastle, Newcastle, NSW, Australia.
Lancet (London, England)
|November 13, 2014
まとめ
戦略的研究と集中的な予防は,怪我後の腹部部症候群 (ACS) の症例を大幅に減少させました. この致命的な状態は,ダメージ制御手術と積極的な液体蘇生に関連しており,現在,改訂されたトラウマケアプロトコルにより,患者のアウトカムが改善されています.
科学分野:
- トラウマ・外科・外科
- クリティカルケア・メディシン
- 手術研究の研究について
背景:
- 怪我後の腹腔症候群 (ACS) は,1990年代に発生し,ダメージコントロール手術と積極的な結晶体蘇生と関連しています.
- この状態は,重症患者の腹内圧力の上昇により致死的な呼吸器,腎臓,心不全を引き起こしました.
- 遅延した出血制御と過剰な結晶剤の使用は,主要な要因として特定されました.
研究 の 目的:
- 怪我後の腹腔症候群 (ACS) の発生と要因を調査する.
- 予防戦略がACSの発生率に与える影響を評価する.
- トラウマ蘇生実践の変化とその結果を理解する.
主な方法:
- 臨床的発生とACSに寄与する要因の分析.
- 伝統的な蘇生基準に挑戦するなど,予防戦略の評価.
- 研究成果を民間および軍事的トラウマ実践に翻訳する見直し.
主要な成果:
- 戦略的研究と集中的な予防は,ACS症例を大幅に減少させました.
- 大量結晶体蘇生の40年間の基準に挑戦することは効果的であることが示されました.
- 発見は急速に採用され,トラウマ患者の蘇生と結果を改善しました.
結論:
- 創傷後の腹部部部症候群 (ACS) は,戦略的研究とターゲットを絞った介入を通じて予防可能な状態です.
- トラウマ蘇生における修正,特に流体管理は,患者の生存率を大幅に改善しました.
- この研究は,研究の臨床実務への成功翻訳を強調し,トラウマケアに革命をもたらしました.
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