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危险因素和管理结果在急诊室的儿科表皮切术
Andrew Shieh1, James A Cranford1, Angela C Weyand2
1Department of Emergency Medicine, University of Michigan, Ann Arbor, Michigan.
The Journal of emergency medicine
|February 2, 2024
概括
儿科表 (鼻血) 可能是严重的,需要访问急诊室 (ED). 老年,之前的ED访问和抗血小板使用预测中度出血,而出血障碍和抗凝血预测严重出血.
科学领域:
- 儿科急救医学 儿科急救医学
- 耳鼻喉科 耳鼻喉科 耳鼻喉科
- 血液学 血液学 血液学
背景情况:
- 大多数儿科表 (鼻血) 病例是轻微的,并自发消失.
- 显著的少数儿童出现在急诊室 (ED) 的中度至重度表需要干预.
研究的目的:
- 为了确定与ED中适度和严重的儿科表症相关的风险因素.
- 探索不同严重程度的表症的管理结果.
主要方法:
- 从2013年至2022年,对858名儿科患者 (<22岁) 进行了回顾性审查,这些患者在2013年至2022年期间呈现了ED的表.
- 表症的严重程度分类:轻度,中度 (需要烧结/包装),严重程度 (需要因子替代,输血,入院或手术).
- 单变量和多项回归分析以确定基于表症严重程度的风险因素和结果.
主要成果:
- 适度的表皮 (5%) 与年龄较大,最近的ED访问和抗血小板使用有关.
- 严重的表 (8%) 与出血障碍,最近的鼻腔手术和使用抗凝药有关.
- 抵达前长时间 (>30分钟) 的出血是中度和重度病例的风险因素. 严重的病例经常需要入院 (77%),输血 (42%),偶尔需要手术 (7%).
结论:
- 儿童的表症严重程度与特定可识别的风险因素有关.
- 虽然大多数儿科鼻血是轻微的,但识别风险因素对于管理中度至重度病例至ED至关重要.
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