预医院针式解压疑似紧张性肺胸部:结果和后果
Harrison J Travis1, Gilbert V Andry1, Colin C Rutner2
1School of Medicine, Louisiana State University Health Sciences Center, New Orleans, LA, USA.
The American surgeon
|April 5, 2024
概括
治疗紧张性肺胸 (TPT) 的医院前针式减压 (PHND) 可以导致严重的并发症,如果临床上没有说明. 这项研究发现,在没有明确标准的情况下进行PHND会导致阳性损伤和不必要的手术.
科学领域:
- 紧急医疗 紧急医疗
- 创伤外科 手术 创伤外科
- 在医院前的护理.
背景情况:
- 紧张性肺胸 (TPT) 是一种危及生命的疾病,需要立即介入.
- 医院前针式减压 (PHND) 是TPT在现场的关键程序.
- 当临床标准未完全满足时,PHND的适当性需要评估.
研究的目的:
- 评估在不符合既定临床标准的情况下进行的医院前针脱压 (PHND) 引起的并发症.
- 分析阳性损伤的发生率和随后的患者结局.
主要方法:
- 在2016年至2022年期间在一级创伤中心接受PHND的患者的回顾性评估.
- 分析患者数据,重点关注那些不符合PHND至少一个临床标准的患者.
- 有关并发症的文件,包括需要进行胸腔导管,阳性肺胸部和血管损伤.
主要成果:
- 在115名患者中,有85名 (74%) 患者不符合PHND的至少一个临床标准.
- 绝大多数 (89%) 需要进行胸腔导管,而25%的患者患上了阳性肺胸炎.
- 五名患者 (6%) 由于阳性PHND而入院,两名血管受伤需要紧急手术.
结论:
- 在没有明确的迹象的情况下进行医院前针式减压与严重的负面后果有关.
- 不必要的手术和阳性损伤,包括血管创伤,可能是不适当的PHND的结果.
- 遵守PHND的严格临床标准至关重要,以尽量减少患者的伤害和资源利用.
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