肋骨骨折的止痛疗法:一个叙事审查
Theunis van Zyl1, Anthony M-H Ho1, Gregory Klar1
1Department of Anesthesiology and Perioperative Medicine, Queen's University, Kingston, ON, Canada.
概括
肋骨骨折是一种严重的伤害,死亡率高. 多模式止痛和多学科护理可以减少并发症,但目前肋骨骨折的风险分层工具往往不准确.
科学领域:
- 创伤护理的护理人员.
- 疼痛管理 疼痛管理
- 关键护理医学 关键护理医学
背景情况:
- 肋骨骨折是常见的,痛苦的伤害导致显著的发病率和死亡率,特别是在老年患者.
- 有效的管理侧重于风险分层和多模式止痛,以减轻呼吸系统问题等并发症.
- 慢性疼痛和残疾是肋骨骨折的潜在长期后果.
研究的目的:
- 对管理肋骨骨折的现有证据和护理途径进行审查.
- 确定有效的风险分层工具和镇痛策略.
- 突出多式联通方式在降低发病率和死亡率方面的重要性.
主要方法:
- 对现有文献进行了叙述性审查.
- 使用PubMed和Embase数据库进行了搜索.
- 内容专家审查了已识别的文献.
主要成果:
- 确定了四种风险分层工具; 关于管理粗胸壁创伤的研究得分显示了最具预测价值.
- 审查了各种药理学药物的证据 (乙氨基,NSAIDs, gabapentinoids, ketamine, lidocaine, dexmedetomidine) 和区域止痛技术 (胸部外周,准脊椎,直立脊柱平面,前平面块).
- 研究了肋骨骨折和相关并发症的病理生理学,包括慢性疼痛.
结论:
- 肋骨骨折仍然是一个严重的诊断,与高死亡率,慢性疼痛和残疾有关.
- 采用多学科的方法,适当的止痛药和遵守规范,可以降低发病率和死亡率.
- 目前风险分层的护理途径表明死亡率和并发症的预测性表现不佳.
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