上肢的长期功能结果:平民血管创伤
Colten Yahn1, Maha H Haqqani1, Andrea Alonso1
1Division of Vascular and Endovascular Surgery, Boston Medical Center, Boston University Chobanian and Avedisian School of Medicine, Boston.
Journal of vascular surgery
|November 22, 2023
概括
民用上肢血管创伤 (UEVT) 往往导致长期功能缺陷和慢性疼痛. 早期干预和全面的后续护理对于管理这些结果和减少阿片类药物依赖至关重要.
科学领域:
- 创伤外科 手术 创伤外科
- 血管外科 血管外科
- 整形外科手术 整形外科手术
背景情况:
- 有限的民用数据存在于上肢血管创伤 (UEVT) 的长期结果.
- 了解UEVT的功能后果对于改善患者护理至关重要.
- 民用创伤中心在管理UEVT时面临着独特的挑战.
研究的目的:
- 在平民创伤群体中评估UEVT的管理策略.
- 探索UEVT后的长期功能结果和后果.
- 确定影响康复的因素,并确定改善患者管理的领域.
主要方法:
- 在城市1级创伤中心对150名UEVT患者的回顾性评估 (2001-2022年).
- 分析患者的人口统计,损伤机制和管理干预措施.
- 评估长期功能结果,包括疼痛,神经缺陷和恢复工作.
主要成果:
- 大多数UEVT患者是年轻男性,穿透创伤 (79%) 是常见的原因.
- 开放式修复与自身静脉绕道是主要的手术方法 (92%).
- 显著的长期问题包括慢性疼痛 (56%),运动/感官缺陷 (54%/61%) 和延迟返回工作 (39%).
结论:
- UEVT与严重的长期功能障碍和慢性疼痛的高患病率有关.
- 很大一部分患者经历了持续的神经缺陷和日常生活中的困难.
- 出院时使用阿片类药物很常见,在6个月后仍然使用阿片类药物的百分比很高,这凸显了需要仔细管理和跟踪的需要.
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