与枪支相关的血管损伤的管理和结果
Karolina Nyberger1,2,3, Eva-Corina Caragounis4, Pauline Djerf5
1Department of Molecular Medicine and Surgery, Karolinska Institute, 171 76, Stockholm, Sweden. karolina.nyberger@gmail.com.
概括
枪支血管损伤是一个重要的公共卫生问题,下肢损伤是最常见的,但胸部和腹部损伤证明最致命. 早期的出血控制对于改善这些关键血管创伤病例的生存率至关重要.
科学领域:
- 血管外科 血管外科
- 创伤外科 手术 创伤外科
- 公共卫生 公共卫生
背景情况:
- 枪支暴力是全球公共卫生面临的一个重大挑战.
- 枪支造成的血管损伤与高死亡率有关.
- 了解这些伤害的流行病学对于开发有效的干预措施至关重要.
研究的目的:
- 分析与枪支相关的血管损伤的基于人口的流行病学.
- 识别由枪支造成的血管创伤的模式,位置和结果.
- 为减少与枪支血管损伤相关的发病率和死亡率的战略提供信息.
主要方法:
- 在2011年至2019年期间,使用瑞典创伤登记处 (SweTrau) 的数据进行了一项回顾性全国性流行病学研究.
- 这项研究包括71,879名创伤患者,确定了1010名枪支受伤者,其中162人患有血管损伤.
- 数据分析的重点是患者人口统计学,损伤特征,手术干预和死亡结果.
主要成果:
- 162名患者患有238种与枪支有关的血管损伤,主要影响下肢 (41.7%),腹部 (18.9%) 和胸部 (18.9%).
- 常见的股骨动脉损伤是最常见的 (17.6%). 在37.7%的患者中观察到血液动力学不稳定性,胸前主动脉和大腿动脉损伤在这个小组中最常见.
- 30天和90天的死亡率分别为29.9%和33.3%. 胸部或腹部血管损伤,特别是胸前大动脉或大腿动脉,与24小时死亡率的增加有关.
结论:
- 与枪支相关的血管损伤导致大量的发病率和死亡率.
- 虽然下肢损伤最常见,胸部和腹部血管损伤的死亡率最高.
- 加强早期出血控制策略对于改善枪支血管创伤患者的治疗结果至关重要.
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