疑似虐待儿童头部创伤 - 什么时候他们真的需要被转移到神经外科病房?
Aled Lester1, Zoe James2, Dmitri Sastin2
1Cardiff University School of Medicine, Cardiff, UK.
British journal of neurosurgery
|August 26, 2023
概括
大多数被转移到神经外科中心的滥用头部创伤 (AHT) 患者不需要手术. 只有在临床上必要时才转移AHT患者,可以改善保护调查和患者护理.
科学领域:
- 儿科神经外科 儿科神经外科
- 儿童保护 儿童保护
- 法医医学 法医医学
背景情况:
- 将疑似滥用头部创伤 (AHT) 的儿科患者转移到专门的神经外科中心,可能会破坏关键的保护调查.
- 及时和适当的转移至关重要,但不必要的转移可能会阻碍调查和患者管理.
研究的目的:
- 为了分析疑似AHT患者的转诊模式,将其转诊到三级儿科神经外科中心.
- 为了为AHT患者的未来转移决定提供信息,平衡临床必要性与调查需求.
主要方法:
- 在2012年至2021年期间推的疑似AHT患者的回顾性审查.
- 转移和未转移患者之间的手术率,输管,通风,放射学发现和格拉斯哥昏迷表 (GCS) 的比较.
- 根据临床和放射学特征计算神经外科移植的几率比率.
主要成果:
- 在76名转诊患者中,有18人被转诊;只有1人需要手术,而大多数人接受了支持性护理.
- 转移的患者经常出现皮下血瘤 (SDHs) 和GCS ≥13在呈现时.
- 患有GCS≥13和SDH,双边血瘤或吐的患者转移的可能性明显更高.
结论:
- 大多数转移的AHT患者不会接受手术干预.
- 转移应该保留给可能需要手术的病例,允许其他人留在当地以保护调查.
- 如果急诊手术不太可能,可能不需要立即转移AHT患者的GCS≥13和特定发现 (吐,SDHs,双边血液瘤).
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