对儿科无脉冲的粉红色大腿骨上骨折进行系统审查
Wei Chong Keith Goh1, Eric J Y Ong, Nicole Kim Luan Lee
1Department of Orthopaedic Surgery, KK Women's and Children's Hospital and Lee Kong Chian School of Medicine.
Journal of pediatric orthopedics. Part B
|January 8, 2024
概括
儿童的骨骨折可能会导致无脉动但粉红色的手. 建议密切观察和非侵入性监测,为血管恶化的迹象保留手术.
科学领域:
- 整形外科手术 整形外科手术
- 儿科整形外科 儿科整形外科
- 血管外科 血管外科
背景情况:
- 超状骨折 (SCHF) 是最常见的儿科肘部骨折.
- 在SCHF后的粉红色无脉动手 (PPH) 的管理是有争议的.
- 在PPH中,手臂动脉的探索在外科医生之间进行了辩论.
研究的目的:
- 审查关于在儿科上下垂骨骨折 (SCHF) 后的粉红色无脉动手 (PPH) 管理的文献.
- 评估与PPH管理相关的当前策略,结果和并发症.
- 为PPH的有争议的临床场景提供基于证据的建议.
主要方法:
- 电子数据库的系统文献审查 (PubMed,Embase).
- 对23篇文章的分析,重点是SCHF后的PPH管理.
- 对336个PPH病例进行了管理,后续和并发症的评估.
主要成果:
- 密切观察被认为是PPH最可靠的策略.
- 对于SCHF来说,立即减少和固定至关重要.
- 24-48小时的非侵入性监测 (超声波多普勒,脉冲氧计) 显示出良好的结果.
结论:
- 如果没有发生血管恶化,建议在SCHF后对PPH进行警等待.
- 非侵入性监测工具对于评估PPH的输液非常有价值.
- 对于血管恶化的迹象或手部并发症,建议立即进行血管探索.
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