在的腹部创伤中空洞粘膜穿孔:来自创伤中心的14年的经验
Veronica I Rodriguez1,2, Barbara Perez1, Andrea Fernandez1
1Department of General Surgery, Hospital General del Este "Dr. Domingo Luciani", Universidad Central de Venezuela, Caracas, Venezuela.
World journal of surgery
|February 14, 2024
概括
的腹部创伤 (BAT) 很少导致空洞粘液 (HV) 穿孔,但它们的发生率正在增加. 延迟诊断是常见的,强调需要基于创伤患者的临床评估进行手术干预.
科学领域:
- 创伤外科 手术 创伤外科
- 胃肠道手术 胃肠道手术
- 紧急医疗 紧急医疗
背景情况:
- 空洞粘膜 (HV) 穿孔很少 (<1%) 在的腹部创伤 (BAT),通常与对固定肠道段的高冲击力有关.
- 现有的文献缺乏最新的关于在BAT之后HV穿孔的数据,特别是在低收入医疗机构.
研究的目的:
- 为了确定"多明戈·卢西亚尼博士"总医院 (HDL) 在的腹部创伤 (BAT) 中严重的HV损伤的发生率.
- 解决与BAT相关的现代高温穿孔相关的文献缺口,重点关注低收入环境.
主要方法:
- 在14年内对被诊断患有复杂的BAT和HV穿孔的患者进行了医疗记录的回顾性审查.
- 数据分析包括患者人口统计,伤害严重程度,手术发现和诊断时间表.
主要成果:
- 在761名BAT患者中,6.04%的患者在紧急手术期间出现了HV穿孔.
- 在44.44%的病例中,单独的HV损伤发生;阴和横横结肠病变 (分别为II-III级和I级) 是最常见的.
- 观察到BAT次要的HV损伤的趋势越来越大,往往诊断延迟.
结论:
- 尽管取得了进展,但在BAT中对HV穿孔的延迟诊断仍然是一个挑战,特别是在资源有限的环境中.
- 应优先考虑基于创伤机制,血液动力学状态和临床再评估的手术探索,即使使用非诊断成像.
- 这项研究强调了需要提高意识和及时手术管理的HV伤害在的腹部创伤.
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