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严重多创伤后的肺栓塞:来自中国一级创伤中心的回顾性研究
Qiqi Wu1, Jie Wu2, Shufen Tian1
1Department of Trauma Surgery, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, People's Republic of China.
概括
严重创伤患者的肺栓塞 (PE) 呈现独特,通常没有深静脉血栓塞 (DVT),并且具有明显的危险因素. 这凸显了在创伤护理中针对PE进行量身定制的预防策略的需要.
科学领域:
- 创伤外科 手术 创伤外科
- 血管医学 血管医学
- 关键护理医学 关键护理医学
背景情况:
- 严重创伤患者面临高风险的静脉血栓塞栓症 (VTE).
- 与深静脉血栓症 (DVT) 相比,关于创伤后肺栓塞 (PE) 的数据不太确立.
- 这项研究研究PE作为严重多创伤的独特临床实体.
研究的目的:
- 为了确定严重创伤中的PE是否在受伤模式方面与DVT不同.
- 在创伤患者中确定与PE相关的独特风险因素.
- 评估当前的预防策略是否需要对PE进行调整.
主要方法:
- 从一级创伤中心 (2011-2021) 来重症多创伤患者的回顾性分析.
- 患者分为:没有VTE,只有DVT,只有PE,和PE与DVT.
- 后勤回归用于确定不同VTE模式的独立风险因素.
主要成果:
- 在3498名患者中,PE发生在82例患者中 (19例仅PE,63例PE与DVT).
- 冲击和严重的胸部创伤仅与PE有关.
- 严重的骨盆骨折和长时间的机械通风是PE与DVT的风险因素.
- 早期PE与肥胖和下肢损伤相关;晚期PE与头部损伤和更高的ISS相关.
结论:
- 在严重创伤患者中,PE通常是早期事件,并且可以独立于DVT发生.
- 不同的伤害模式和风险因素需要特别注意PE.
- 在严重创伤患者中,对PE的预防策略可能需要重新评估.
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