了解成年创伤中心青少年突发创伤患者的胸部CT扫描使用情况
Lilly Groszman1, Kem-Maria McCook1, Laurel Xiang2
1Department of Surgery, Morehouse School of Medicine, Atlanta, GA, USA.
The American surgeon
|August 24, 2023
概括
胸部计算机断层扫描 (CCT) 可能对于青少年重创伤患者来说并不重要. 临床检查和胸部X射线 (CXR) 可以有效地识别胸部创伤,减少辐射暴露.
科学领域:
- 紧急医疗 紧急医疗
- 放射学 放射学是一门学科.
- 创伤外科 手术 创伤外科
背景情况:
- 胸部计算机断层扫描 (CCT) 在青少年突击创伤患者的诊断实用性仍然不清楚.
- 建立最佳的诊断算法对于有效的创伤护理至关重要.
研究的目的:
- 评估CCT在初步评估经历重物质创伤的青少年患者中的作用和必要性.
- 为了确定CCT是否提供了超越标准临床评估和X射线图的关键信息.
主要方法:
- 在城市一级成人创伤中心 (2015-2019) 接受治疗的青少年重创伤患者的回顾性审查.
- 分析了CCT发现,患者人口统计,损伤严重程度得分 (ISS),格拉斯哥昏迷表 (GCS) 和胸部X射线 (CXR) 的结果.
- 使用单变量和多变量逻辑回归分析来确定积极的CCT结果的预测因素.
主要成果:
- 在288名患者中,153名患者的CCT结果为阳性. 阳性CCT与较高的ISS,较低的GCS,阳性CXR,胸痛和异常的胸部检查结果有关.
- 积极的CXR和ISS独立地与多变量分析中的积极的CCT结果相关 (分别为OR=13.96和3.10).
结论:
- 结合胸部X射线 (CXR) 的临床检查可能足以诊断青少年突击创伤患者的胸部创伤.
- 减少对CCT的依赖可能会尽量减少辐射暴露,而不会影响成人创伤中心的患者护理.
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