随机对照试验的手术肋骨固定到非手术管理在严重的胸壁损伤
David E Meyer1, John A Harvin1, Laura Vincent2
1Department of Surgery; McGovern Medical School at UTHealth Houston, Houston, TX.
Annals of surgery
|June 15, 2023
概括
肋骨骨折的手术稳定 (SSRF) 没有改善严重的胸壁损伤的结果,没有临床胸部. SSRF增加了住院时间,并提供了高达六个月的生命质量福利.
科学领域:
- 创伤外科 手术 创伤外科
- 胸部外科手术 胸部外科手术
- 关键护理医学 关键护理医学
背景情况:
- 已知肋骨骨折的手术稳定 (SSRF) 可以改善患有胸部和呼吸衰竭的患者的治疗结果.
- 在严重的胸壁损伤中,SSRF的有效性在没有临床胸部损伤的情况下仍然不清楚.
研究的目的:
- 为了比较SSRF与非手术治疗在严重的胸壁损伤中的有效性.
- 评估SSRF对住院时间,ICU住院时间,呼吸机日,阿片类药物使用,死亡率和生活质量的影响.
主要方法:
- 一项随机对照试验,涉及84名患有严重胸壁损伤的患者.
- 患者被随机分配到SSRF或非手术管理.
- 主要结局是住院时间长度;次要结局包括ICU住院时间长度,呼吸机日,阿片类药物暴露,死亡率和生活质量得分.
主要成果:
- 住院时间在SSRF组显著更长 (RR: 1.48).
- 在各组之间,重症监护室停留时间和呼吸机日数在各组之间相似.
- 一个月后,SSRF患者报告说,移动和自我照顾的障碍更大.
结论:
- 对于长达六个月重度胸壁损伤的患者来说,SSRF并没有为生活质量带来好处.
- SSRF增加了住院时间,但没有改善其他关键结果.
- 对于严重的胸壁损伤而没有临床胸,可能更喜欢非手术治疗.
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