在患者的肋骨固定定时与胸部的患者
Devanshi D Patel1, Benjamin R Zambetti1, Louis J Magnotti2
1Department of Surgery, University of Tennessee Health Science Center, Memphis, Tennessee.
The Journal of surgical research
|October 22, 2023
概括
在4天内早期手术固定胸部 (FC) 可以减少肺部并发症和住院时间. 对FC的手术肋骨固定 (ORIF) 改善了生存率,早期干预改善了结果.
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:
- 突击创伤后的胸部 (FC) 风与严重的并发症和延长住院时间有关.
- 对FC的最佳管理策略,特别是手术干预的时间,需要进一步研究.
研究的目的:
- 调查手术肋骨固定时间 (ORIF) 与FC患者肺部发病率和死亡率之间的关联.
- 确定ORIF的最佳时间窗口,以尽量减少不良结果.
主要方法:
- 对来自创伤质量改善计划 (2016-2019) 的20457名FC患者的回顾性分析.
- 对ORIF与非手术治疗之间的结果比较,以及早期 (≤4天) 与晚期 (>4天) ORIF之间的结果比较.
- 多变量逻辑回归和尤登指数被用来确定最佳时间和预测结果的指标.
主要成果:
- 与非手术治疗相比,ORIF与肺部发病率增加有关,但死亡率显著降低 (2.9%与11.7%相比).
- 早期ORIF (≤4天) 与呼吸器日数减少,ICU/住院时间长度以及肺部发病率有关.
- ORIF是唯一与降低死亡率显著相关的可修改因素 (OR:0.26).
结论:
- 对FC的ORIF提供了死亡率的好处,尽管最初的肺部发病率可能更高.
- 在受伤后4天内执行ORIF可能会减轻肺部并发症,缩短住院时间,但不会影响生存效益.
- 早期的ORIF是改善胸患者治疗结果的关键考虑因素.
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