上肢自行造成的非意外截肢的管理:系统审查
Helene Retrouvey1, Amy Franks2, Thom Dunn2
1Division of Orthopedic Surgery, University of Colorado School of Medicine, Denver Health Medical Center, Denver, CO.
The Journal of hand surgery
|August 17, 2023
概括
自我造成的上肢截肢的移植通常是成功的,即使在精神病失补偿的情况下也是如此. 外科医生应考虑重新植入,除非受伤因素禁忌,并且在拒绝治疗的患者咨询精神病学.
科学领域:
- 医学研究 医学研究
- 外科手术的结果
- 精神病的并发症 精神病的并发症
背景情况:
- 蓄意自杀截肢可能会导致复杂的临床决策.
- 管理需要仔细考虑外科和精神病学因素.
研究的目的:
- 系统地审查关于自制上肢截肢的文献.
- 为这些损伤的急性管理和再植栽提供基于证据的建议.
主要方法:
- 在四个数据库中进行了系统的文献搜索.
- 关键词包括"上肢"",截肢"和"自杀".
- 来自24项报告29例病例的研究数据进行了叙事综合.
主要成果:
- 大多数截肢发生在手/手腕或前臂,通常使用或刀.
- 精神病,自杀企图,抑郁和身体完整性认同障碍是常见的原因.
- 进行了15次重植成功;不进行重植的原因是受伤相关,而不是患者相关.
结论:
- 精神病失补偿并不是再移植的绝对禁忌;患者经常报告稳定后的满意度.
- 身体完整性认同障碍可能导致有意识地拒绝移植.
- 与精神病学的合作对于管理急性精神病失偿症患者的关键,这些患者拒绝或无能力同意再移植.
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