在III-V级骨损伤的非手术治疗前后实施方案:一项观察性研究
Ismail Mahmood1, Basil Younis1, Mohammad Alabdallat1
1Department of Surgery, Trauma Surgery Section, Hamad Medical Corporation (HMC), Doha, Qatar.
Heliyon
|April 1, 2024
概括
实施标准化协议显著提高了三级至五级骨损伤 (BSI) 的非手术管理 (NOM) 成功率. 这种方法增加了脏血管栓塞和随访CT扫描,减少了输血,同时保持了安全.
科学领域:
- 创伤外科 手术 创伤外科
- 干预性放射学 干预性放射学
- 紧急医疗 紧急医疗
背景情况:
- 在血液动力学稳定的患者中,III-V级的形脏损伤 (BSI) 对非手术治疗 (NOM) 提出了挑战.
- 2014年,针对稳定,中等和高等级的BSI,实施了一项涉及脏血管造影和栓塞的标准化治疗方案.
- 该协议还包括对III级BSI进行后续CT扫描.
研究的目的:
- 评估NOM中等级和高等级BSI的成功率.
- 评估1级创伤中心标准化治疗方案的影响.
- 确定该协议是否改善了结果和资源利用.
主要方法:
- 一项观察性回顾性研究分析了卡塔尔国家创伤登记处 (2011年6月至2019年9月) 的数据.
- 患有BSI等级III-V的患者被分为协议实施前和后的组.
- 人口统计,伤害等级,成像发现,干预措施和结果在各组之间进行了比较.
主要成果:
- 在协议后,NOM率从50.6%增加到65.6% (p=0.02).
- 输血需求显著下降 (64.2%至45.9%,p=0.007).
- 脊髓血管栓塞和CT随访在协议后组显著增加.
结论:
- 非操作性管理 (NOM) 对于III-V等级的BSI来说是有效和安全的.
- 标准化指导方针提高了骨损伤的NOM成功率,并减少了不必要的腹腔切除术.
- 脏血管栓塞是NOM的重要补充,提高了治疗成功率.
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