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在不稳定的隔离腹部创伤患者中,立即或适当的突发性腹腔切除术

P Maya^1,2, B Moran^2,3, M Khan⁴

¹Schneider Children's Medical Center, Petah Tikva, Israel.

Annals of the Royal College of Surgeons of England

|June 5, 2024

概括

对于不稳定的腹部创伤,立即腹腔切除术增加了严重重创伤患者的死亡率 (ISS ≥16,GCS <15). 穿透创伤没有根据手术时间显示出结果的差异.

科学领域:

创伤外科手术创伤外科
紧急医疗紧急医疗
手术结果研究研究.

背景情况:

不稳定的腹部创伤需要紧急腹腔切除术.
有限的研究存在于时间到手术对这些关键患者的生存的影响.
这项研究探讨了手术时间和结局在和穿透腹部创伤之间的关系.

研究的目的:

评估腹腔切除术时间对患者结果的影响.
根据新出现的腹腔切除术的时间来比较生存率.
对于手术紧急情况,要区分形和穿透腹部创伤之间的结果.

主要方法:

在以色列医院 (2000-2018) 住院的不稳定腹部创伤患者的回顾性分析.
纳入标准:收缩压血压<90mmHg到达时.
收集的数据:来自以色列国家创伤登记处的患者人口统计数据,伤害严重性得分 (ISS),格拉斯哥昏迷表 (GCS),手术时间,住院时间和死亡率.

主要成果:

这项研究包括69名突击受伤患者和127名穿透创伤患者.
对于 ISS ≤14 的或穿透创伤患者,无论在60分钟或60-120分钟内进行腹腔切除术,都没有观察到显著的结果差异.
患有重创伤,ISS ≥16和GCS <15的患者经历了立即腹腔切除的更高死亡率 (p=0.004和p=0.049).

结论:

对于透腹部创伤,立即或即时腹腔切除并没有显著影响死亡率.
在严重的形腹部创伤 (ISS ≥16,GCS <15) 中,立即腹腔切除与死亡率增加有关.
在不稳定的腹部创伤中,手术时间可能会根据受伤类型和严重程度产生不同的影响.

关键词:

腹部创伤腹部创伤紧急外科手术紧急外科手术拉皮切除术 (Laparotomy) 是一个切除术.死亡率死亡率死亡率手术时间手术时间

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