针对上肢骨折进行手术治疗的患者进行6周的常规门诊:它真的必要吗?
Thomas P Bosch1, Felix Peuker2, Frank J P Beeres3
1Department of Trauma Surgery, Leiden University Medical Center, Leiden, the Netherlands; Department of Trauma Surgery and Orthopedics, Lucerne Cantonal Hospital, Lucerne, Switzerland.
Journal of shoulder and elbow surgery
|July 3, 2024
概括
常见的上肢骨折手术后6周的例行术后访问和X射线很少显示出临床上显著的异常或导致治疗变化. 对后续护理采取更有选择性的方法可能是合理的.
科学领域:
- 整形外科手术 整形外科手术
- 创伤护理 创伤护理
- 放射学 放射学是指放射学
背景情况:
- 医疗保健系统面临越来越多的负担,需要评估常规后续协议.
- 对于手术治疗上肢骨折的标准6周门诊和放射检查的有效性受到质疑.
研究的目的:
- 为了研究常见的上肢骨折的手术治疗后的6周例行门诊诊所和X线图的临床效用.
- 在6周的随访期内确定放射性异常和标准护理方案偏差的发生率.
主要方法:
- 对267名接受上肢骨折手术的患者进行了回顾性队列研究 (2019-2022年).
- 对放射性异常 (术后与6周) 的分析及其临床后果.
- 从标准术后治疗和随访方案中偏差的评估.
主要成果:
- 在6周内,只有3.7%的患者表现出放射性异常,其中1.5%具有临床影响.
- 偏离标准护理方案仅发生在3.0%的患者中,通常与症状并发症有关.
- 大多数6周的例行检查和X射线检查结果几乎没有任何可行的结果.
结论:
- 对于常见的上肢骨折的手术后,常规的6周的门诊和X射线检查的临床影响有限.
- 应考虑采取更有选择性的后续战略,以优化医疗保健资源分配.
- 常规成像和检查的必要性要求重新评估以有利于以患者为中心,潜在的症状驱动的后续护理.
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