十二指肠损伤严重程度,修复和死亡率的趋势随着时间的推移
Chinweotuto V Uma1, William B Risinger2, Samantha J Baker3
1Department of Surgery, University of Louisville School of Medicine, Louisville, Kentucky.
The Journal of surgical research
|August 23, 2024
概括
与枪支相关的十二指肠损伤显著增加,较高等级变得越来越常见. 尽管如此,使用了简单的修复技术,死亡率保持不变.
科学领域:
- 创伤外科 手术 创伤外科
- 外科手术的结果
- 伤害流行病学 伤害流行病学
背景情况:
- 创伤性十二指肠损伤的结果取决于损伤位置,严重程度和相关损伤.
- 枪支伤害的增加可能会影响十二指甲骨损伤的严重程度,修复方法和患者死亡率.
- 调查十二指肠损伤管理的趋势对于改善患者护理至关重要.
研究的目的:
- 调查枪支伤害的增加与十二指肠损伤的严重程度之间的关联.
- 分析随着时间的推移,对十二指肠损伤的手术修复技术的趋势.
- 确定改变伤害模式对创伤性十二指甲骨损伤死亡率的影响.
主要方法:
- 从2000年到2022年,在一级创伤中心管理的十二指肠损伤的回顾性分析.
- 收集的数据包括人口统计,伤害类型 (枪支与其他),美国创伤外科协会 (AAST) 级别和修复方法.
- 数据被汇总成两个时期 (2000年至2011年和2011年至2022年),以评估时间趋势.
主要成果:
- 观察到与枪支相关的十二指肠损伤显著增加 (30%至55%,P < 0.001).
- 随着时间的推移,较高级别的十二指肠损伤 (AAST 24级) 的比例有所增加 (P = 0.002),其中枪支损伤主要导致较高级别的损伤 (P < 0.001).
- 尽管高度伤害增加,但使用带管排水或没有管道排水的初级修复仍然是一致的 (61%对70%,P=0.35),整体死亡率没有显著变化 (15%对17%,P=0.62).
结论:
- 由于枪支造成的十二指肠损伤的比例增加.
- 与枪支相关的伤害与较高级别的十二指腺创伤有关.
- 简单的修复技术仍然有效地管理这些伤害,在研究期间没有观察到死亡率的显著增加.
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