从早期的全方位护理到早期的适当护理 - - 每个麻醉医生必须知道的!
Babita Gupta1, Kamran Farooque2
1Department of Anesthesiology, Pain Medicine and Critical Care, Jai Prakash Narayan Apex Trauma Centre, All India Institute of Medical Sciences, New Delhi, India.
Journal of anaesthesiology, clinical pharmacology
|May 30, 2023
概括
损伤控制骨科 (DCO) 从早期的整体护理 (ETC) 和早期的适当护理 (EAC) 演变为管理骨科创伤. 这种方法优先考虑挽救生命的手术,而不是最终的骨折固定,考虑免疫反应.
科学领域:
- 整形外科手术 整形外科手术
- 创伤管理 创伤管理
- 免疫学 免疫学 免疫学
背景情况:
- 骨科创伤管理已经通过几个阶段发展:保守治疗,早期整体护理 (ETC),损伤控制骨科 (DCO) 和早期适当护理 (EAC) /安全的最终手术 (SDS).
- "双击理论"出现了,表明最初的伤害 ("第一击") 随后的外科创伤 ("第二击") 可以增加并发症.
- 这一理论影响了推迟创伤后2-5天的最终手术,以减轻与早期干预相关的风险.
研究的目的:
- 审查损害控制骨科 (DCO) 的历史演变.
- 探索患者对创伤和手术反应背后的免疫机制.
- 识别DCO或EAC/SDS管理的伤害,并讨论麻醉方面的考虑.
主要方法:
- 文献综述侧重于骨科创伤管理策略的历史观点.
- 在多创伤患者中分析免疫过程和"双击理论".
- 对DCO和EAC/SDS的临床结果和麻醉管理的检查.
主要成果:
- DCO涉及最初的挽救生命或肢体的手术,然后在患者稳定后延迟最终固定.
- "双击理论"强调了手术压力对创伤患者的影响,支持推迟最终手术.
- 讨论了DCO和EAC/SDS方法的特定伤害和麻醉方案.
结论:
- 骨科创伤护理的发展反映了对患者生理学和手术影响的越来越深入的理解.
- 损伤控制骨科和早期适当的护理代表了管理复杂多创伤的战略转变.
- 麻醉管理对于优化DCO或EAC/SDS.患者的治疗结果至关重要.
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