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简单的参数来识别可用早期永久固定治疗的患者:全国性的研究

Kazuhiko Udagawa¹, Ryo Yamamoto², Naotaka Shimatani²

¹Department of Emergency and Critical Care Medicine, Keio University School of Medicine, 35 Shinanomachi, Shinjuku, Tokyo 160-8582, Japan; Department of Orthopedic Surgery, Keio University School of Medicine, Japan.

|October 23, 2023

概括

早期最终固定 (EDF) 对于创伤患者来说是安全的,格拉斯哥昏迷表得分为13或更高,缩血压为90mmHg或更高,伤害严重程度得分低于15. 这些因素有助于确定早期骨折治疗的最佳候选人.

科学领域:

创伤外科手术创伤外科
整形外科手术整形外科手术
关键护理医学关键护理医学

背景情况:

早期适当护理 (EAC) 和早期最终固定 (EDF) 是对多次受伤患者的四肢骨折管理的公认策略.
然而,EDF的最佳患者选择标准仍然没有得到验证,需要进一步的研究.

研究的目的:

确定简单的临床参数来选择可以安全地接受早期最终固定 (EDF) 的创伤患者.

主要方法:

来自日本创伤数据库 (JTDB) 的12735名四肢损伤患者的回顾性分析.
接受开放性减轻和内部固定治疗的患者根据格拉斯哥昏迷表 (GCS) 评分,缩血压 (sBP) 和损伤严重性评分 (ISS) 进行了分类.
在这些类别中,EDF和非EDF组之间的住院死亡率进行了比较.

主要成果:

29.1%的符合条件的患者 (3706/12,735) 接受了EDF的治疗.
在GCS<13,sBP<90 mmHg和ISS≥15.5的患者中,EDF与更高的住院死亡率有关.
在GCS≥13,sBP≥90 mmHg和ISS<15.0的患者中,EDF和非EDF组之间没有观察到医院死亡率的显著差异.

结论:

具有GCS分数≥13,sBP≥90 mmHg和ISS<15的患者可以在不增加死亡率的情况下接受EDF.
这些临床参数作为有价值的查工具,用于选择适当的候选人,以便在创伤护理中早期确定.

关键词:

早期的最终固定 (EDF)极端肢体受伤的情况固定时间的定时.骨折外科手术骨折手术骨折手术多重创伤的人有关生命的重要迹象

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