在二级创伤中心进行针切胸口术的回顾性分析
Sarthak Parikh1,2,3, Maryavis Howell1, Hung-Wen Yeh4,5
1Trauma Institute, Saint Francis Health System, Tulsa, USA.
Cureus
|April 8, 2024
概括
对于张力肺胸部而言,医院前针式减压往往是不必要的,患者生命体征的改善有限. 这种侵入性手术存在风险,包括导管脱落,特别是在第二个肋间间空间中关节线.
科学领域:
- 紧急医疗 紧急医疗
- 创伤护理 创伤护理
- 心胸外科手术 心胸外科手术
背景情况:
- 紧张性肺胸部需要快速进行针式减压,通常是在第二个肋间间空间中关节线 (MCL) 上.
- 文献表明,与第五个肋间间空间中线 (MAL) 相比,第二个ICS MCL的针式减压的失败率更高.
- 临床前提供者可能会过早和不必要地进行针式减压.
研究的目的:
- 评估前医院针式减压治疗张力肺胸部的流行,趋势,疗效和陷.
- 仔细审查由临床前提供者执行的针式减压的指示和结果.
主要方法:
- 追溯审查来自俄克拉荷马州图尔萨的圣弗朗西斯医院的90名患者记录.
- 利用创伤登记数据,史诗高超空间和俄克拉荷马州紧急医疗服务信息系统 (OKEMSIS).
主要成果:
- 常见的症状包括呼吸声减少 (52.70%),缺氧 (15.54%) 和低血压 (6.76%).
- 手术后生命体征的改善是零星的,56.67%的患者表现出改善.
- 导管脱落是最常见的并发症,特别是在第二次ICS MCL. 很少有患者 (n=9) 符合严重缺氧和低血压的标准.
结论:
- 目前的医院前针式减压实践显示,对生命体征的改善很小.
- 生命体征往往不反映压力减压之前的张力肺胸生理学.
- 临床前提供者可能不适当地执行这种侵入性手术,导致潜在的并发症.
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