计算机断层扫描在选择的REBOA导管部署患者中是可行的
Michael C Smith1, Andrew J Medvecz1, Melissa R Smith1
1Vanderbilt University Medical Center, Division of Acute Care Surgery 404 Medical Arts Building, 1211 21st Avenue South, Nashville, TN 37212, USA.
在复苏性内血管气球阻塞大动脉 (REBOA) 放置后进行CT扫描在选择的创伤患者中是可行的. 这种方法可以指导出血流控制管理,尽管在这种严重受伤的人群中死亡率仍然很高.
科学领域:
- 创伤外科 手术 创伤外科
- 紧急医疗 紧急医疗
- 放射学 放射学是一门学科.
背景情况:
- 控制出血对于治疗出血性休克至关重要.
- 复苏性内血管气球阻塞大动脉 (REBOA) 可以暂时控制出血,但鉴定出血源是具有挑战性的.
- 在REBOA期间的计算机断层扫描 (CT) 图像可能有助于血液控制局部化.
研究的目的:
- 为了比较经过REBOA安置后CT扫描的患者与没有接受REBOA安置后CT扫描的患者的结果.
- 评估CT扫描的安全性和实用性,以指导REBOA治疗出血性休克患者的管理.
主要方法:
- 从2017年5月到2021年12月,对61名用REBOA进行CT的患者和25名没有CT的患者进行了回顾性分析.
- 数据来源于AAST AORTA注册表和美国外科医生协会创伤注册表 (TRACS).
- 主要结局:住院死亡率;次要结局:无住院,无ICU和无呼吸器日.
主要成果:
- 接受REBOACT治疗的患者更可能患有形创伤,较高的伤害严重性评分 (ISS),盆腔出血和3区REBOA放置.
- 住院死亡率在各组之间没有显著差异 (51%对64%).
- 在干预放射学中,CT与REBOA与增加的出血控制相关 (43%与0%相比),并且没有自由日的差异.
结论:
- 使用REBOA对精选的创伤患者进行CT扫描是可行的,可以促进迅速的治疗和管理.
- 当进行时,CT成像可以影响最佳的出血控制策略.
- 在这个严重受伤的患者队列中,死亡率仍然很高,无论CT使用情况如何.
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