在多创伤患者中出现急性结肠伪阻塞
Cecil S Johnny1, Richard N Schlegel, Mayurathan Balachandran
1From the Trauma Service (C.S.J., R.N.S., M.B., L.C., J.M., E.-J.B., M.C.F.), Emergency and Trauma Centre (C.S.J., J.M.), and National Trauma Research Institute (C.S.J., J.M., E.-J.B., M.C.F.), The Alfred Hospital; Department of Surgery (C.S.J., J.M., M.C.F.), Central Clinical School, Monash University; Colorectal Unit, Department of Surgery (P.C.), Department of Radiology (D.V.), and Acute General Surgery Unit (E.-J.B.), The Alfred Hospital, Melbourne, Victoria, Australia.
急性结肠伪阻塞 (ACPO) 在多创伤患者中很常见,尤其是老年男性. 危险因素包括冲击,严重伤害,骨盆骨折和阿片类药物使用,需要警监测以获得更好的结果.
科学领域:
- 创伤外科 手术 创伤外科
- 胃肠病学 胃肠病学
- 手术重症监护手术重症监护
背景情况:
- 急性结肠伪阻塞 (ACPO) 呈现为严重的结肠膨胀,没有机械阻塞,造成诊断挑战.
- 它在多创伤患者的发病原因尚不清楚,强调需要进一步调查.
研究的目的:
- 在多创伤患者中调查与ACPO相关的风险因素和临床结果.
- 在这个特定的患者群体中为ACPO现有的有限文献提供有价值的数据.
主要方法:
- 追溯分析1级创伤中心的数据 (2019年7月至2018年6月) 涉及ACPO患者和对照组.
- 使用统计分析,包括后勤回归,以确定重大风险因素和关联.
主要成果:
- 在每1000名患者中,ACPO的发病率为1.7,在重大创伤病例中增加到4.86,主要影响50岁以上的男性.
- 关键关联因素包括冲击指数>0.9,伤害严重性得分>18,阿片类药物使用,后出血和骨盆骨折.
- 体直径≥12厘米与体缺血或穿孔的风险增加有关.
结论:
- 在多创伤中,ACPO是显著的条件,具有已知的风险因素和临床结果.
- 建议对老年患者具有特定伤害和阿片类药物使用高度临床怀疑;早期治疗至关重要.
- 需要进一步的前性研究来验证发现,并提高对ACPO在创伤护理中的理解.
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