创伤性腹腔切除术后的临床失补偿:这可能不是肺栓塞
Saskya E Byerly1, Dina M Filiberto1, Emily K Lenart1
1Department of Surgery, Division of Trauma & Surgical Critical Care, University of Tennessee Health Science Campus, 910 Madison Ave, #220, Memphis, TN 38163, USA.
Injury
|June 7, 2024
概括
在创伤性腹腔切除术后,计算机断层扫描 (CT) 扫描肺栓塞 (PE) 的效率低. 术后不补偿往往是由于手术并发症而不是PE,这表明CT可能对这些患者不必要.
科学领域:
- 创伤外科 手术 创伤外科
- 诊断成像 诊断成像 诊断成像
- 肺栓塞是因为肺栓塞.
背景情况:
- 计算机断层扫描 (CT) 经常用于诊断肺栓塞 (PE) 在创伤腹腔切除术后经历临床失补偿 (CD) 的患者.
- 然而,CT在这种特定的术后环境中的有用性是可疑的,因为症状可能来自手术后果.
研究的目的:
- 为了评估CT扫描的诊断产量,下令在创伤腹腔切除术后进行临床失补偿.
- 在这个患者群体中确定和肺栓塞 (PE) 的发生率.
主要方法:
- 进行了一项单一中心的回顾性队列研究.
- 分析了2019年3月至2022年6月期间接受创伤性腹腔切除术和随后的CDCT成年患者的数据.
- 用描述性统计和物流回归来评估结果.
主要成果:
- 在434名接受CT检测CD的患者中,仅1% (3名患者) 发生了和叶片PE.
- 在51%的CT扫描中发现了腹部,泄漏,液体或伪动脉瘤.
- 在40%的病例中,CT检测结果改变了临床管理,胃肠道受伤和白细胞数量升高预示着需要进行干预.
结论:
- 在创伤性腹腔切除术后,和叶叶肺栓塞 (PE) 的发生率很低.
- 系统性炎症反应综合征 (SIRS) 的症状促使术后CT扫描往往不会导致程序性或抗生素干预.
- 手术后不补偿更常被归因于手术并发症而不是PE.
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