临床特征,治疗和短期预后之间的比较 和透腹部创伤:一个多中心的回顾性队列研究
Yi Liu1, Yunhe Gao2, Zhida Chen3
1Department of Abdominal Trauma Surgery, The First Medical Center of Chinese PLA General Hospital, Beijing 100853, China.
Emergency medicine international
|February 21, 2024
概括
这项研究分析了北京的腹部创伤病例,发现的腹部创伤 (BAT) 患者经历了更长的延迟和更严重的伤害. 较长的住院延误,ICU护理和严重伤害严重性评分 (ISS) 与所有腹部创伤患者的结果更差有关.
科学领域:
- 创伤外科 手术 创伤外科
- 紧急医疗 紧急医疗
- 公共卫生 公共卫生
背景情况:
- 关于中国大城市的腹部创伤特征和管理的有限大规模数据存在.
- 区域医疗中心在管理复杂的创伤病例方面发挥着至关重要的作用.
- 了解临床模式对于改善患者治疗结果至关重要.
研究的目的:
- 分析北京地区医疗中心腹部创伤的临床模式和治疗状况.
- 为了比较粗腹部创伤 (BAT) 与透腹部创伤 (PAT) 的特征和预后.
- 确定影响腹部创伤患者短期生存的因素.
主要方法:
- 在7个北京医疗中心 (2010-2021) 接受治疗的553例腹部创伤病例的回顾性分析.
- 收集的数据包括人口统计,损伤原因,AIS/ISS,时间间隔,器官损伤,手术程序和90天死亡率.
- 统计分析涉及曼·惠特尼U测试,奇平方测试和考克斯比例危险模型进行生存分析.
主要成果:
- 与PAT相比,BAT患者的重伤比例较高,初始血红蛋白水平较低,腹腔镜检查率较低.
- 在BAT情况下,伤害到医院的时间较长,特别是在空洞粘膜伤害子组.
- 总体90天死亡率为11.9%;较长的受伤区域住院时间,ICU治疗和严重的ISS与更差的生存率有关.
结论:
- BAT患者通常需要转移到更高级别的设施,从而增加了医院前和手术前的时间.
- 积极的诊断性腹腔镜检查可能有利于血液动力学稳定的BAT患者,患有空洞粘膜损伤.
- 严重伤害的及时治疗和管理至关重要,因为长时间的间隔和急性护理需求预测预后较差.
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