高度损伤的保守管理
A Aguilera Bazán1, Á Yebes1, M Álvarez-Maestro1
1Servicio de Urología, Hospital Universitario La Paz, Madrid, Spain.
Actas urologicas espanolas
|February 18, 2024
概括
高度损伤的管理已经转向保守的血管栓塞,减少切除术和并发症. 这项研究追踪了20多年来损伤治疗的演变.
科学领域:
- 泌尿器科 泌尿器科 泌尿器科 泌尿器科
- 创伤外科 手术 创伤外科
- 干预性放射学 干预性放射学
背景情况:
- 脏创伤占所有泌尿外科创伤的5%.
- 美国创伤外科手术协会 (AAST) 尺度是分级损伤的标准.
- 高度脏创伤管理越来越倾向于保守的策略,如血管栓塞.
研究的目的:
- 分析高度损伤的管理演变.
- 评估2001年至2022年在一个单一的三级保健中心的治疗趋势.
- 为了比较保守的 (栓塞) 与干预的 (腎切除) 方法.
主要方法:
- 54名高度损伤患者的回顾性描述性研究.
- 数据分为两个时期:2001-2010年和2011-2022年.
- 关键变量:治疗类型 (栓塞与腎切除术).
主要成果:
- 高度创伤的急性切除术从50%降至13.8%.
- 高度创伤的血管栓塞率从23.1%增加到44.8%.
- 对于孤立的损伤,栓塞率从28.6%上升到69.2%,而切除术则从42.8%下降到7.69%.
结论:
- 观察到,对损伤的保守管理有显著的转变.
- 血管栓塞的使用率增加与切除率的降低有关.
- 不断发展的治疗策略导致并发症和切除术的减少.
相关概念视频
Heart Failure Drugs: Inhibitors of Renin-Angiotensin System
431
The activation of the sympathetic nervous system and the renin-angiotensin-aldosterone system (RAAS) contributes to cardiac remodeling, and inhibiting the RAAS is a pharmacological target in heart failure management. As a result, neurohumoral modulation is a crucial treatment principle for managing heart failure. This approach involves using medications like ACE inhibitors (ACEIs), angiotensin receptor blockers (ARBs), β-blockers, mineralocorticoid receptor antagonists (MRAs), and neutral...
431
Dialysis
309
Renal failure occurs when the kidneys lose their ability to filter waste products from the blood effectively. It can be classified into two types: acute renal failure (ARF) and chronic renal failure (CRF).
Acute kidney injury develops suddenly and can be caused by pre-renal causes (e.g., hypovolemia, shock), intrinsic renal causes (e.g., acute tubular necrosis), or post-renal causes (e.g., urinary obstruction). In contrast, chronic renal failure progresses gradually over time and is often...
Acute kidney injury develops suddenly and can be caused by pre-renal causes (e.g., hypovolemia, shock), intrinsic renal causes (e.g., acute tubular necrosis), or post-renal causes (e.g., urinary obstruction). In contrast, chronic renal failure progresses gradually over time and is often...
309
Renal Failure: Dose Adjustments
89
In patients with renal impairment, drugs undergo significant changes in their pharmacokinetics, which require dosage adjustments to ensure safe and effective therapy.
Reduced renal clearance and elimination rate are common outcomes of renal impairment. These alterations lead to a prolonged elimination half-life and an altered apparent volume of distribution for drugs. As a result, dosage adjustments are typically necessary to maintain optimal drug levels in the body.
However, dosage adjustments...
Reduced renal clearance and elimination rate are common outcomes of renal impairment. These alterations lead to a prolonged elimination half-life and an altered apparent volume of distribution for drugs. As a result, dosage adjustments are typically necessary to maintain optimal drug levels in the body.
However, dosage adjustments...
89
Acute Respiratory Failure-V
139
The treatment for acute respiratory failure varies based on factors like the underlying cause, overall health, and severity. A collaborative healthcare team is essential for early detection, often through arterial blood gas analysis. Identifying the cause is the primary goal, with treatment strategies adjusted for ventilation/perfusion (V/Q) mismatch, shunting, or diffusion impairment.
Ensure that patients are monitored continuously for their response to therapy, including changes in...
Ensure that patients are monitored continuously for their response to therapy, including changes in...
139
Antihypertensive Drugs: Direct Renin Inhibitors
629
The renin-angiotensin-aldosterone system (RAAS) is an intricate physiological pathway involving numerous enzymes and hormones, including renin, angiotensin-converting enzyme (ACE), angiotensin I and II, and aldosterone. Imbalances within this system increase the production of angiotensin II and aldosterone. Increased angiotensin II levels promote vasoconstriction and blood pressure elevation. Concurrently, higher aldosterone levels stimulate sodium and water reabsorption in the kidneys,...
629


