严酷的现实:手术治疗肺损伤患者的结果
Omar Hejazi1, Arshin Ghaedi1, Collin Stewart1
1Division of Trauma, Critical Care, Burns, and Emergency Surgery, Department of Surgery, College of Medicine, University of Arizona, Tucson, Arizona.
The Journal of surgical research
|August 29, 2024
概括
创伤性肺损伤的手术治疗具有很高的死亡风险,近三分之一的患者无法生存. 外科手术应保留给特定的病例,特别是那些头部或腹部受伤的人.
科学领域:
- 创伤外科 手术 创伤外科
- 胸部外科手术 胸部外科手术
- 外科手术的结果
背景情况:
- 大多数创伤性肺损伤都是非手术治疗的.
- 最近关于手术性肺损伤结果的数据有限.
- 这项研究评估了手术治疗肺损伤的全国生存率.
研究的目的:
- 确定接受手术管理的创伤性肺损伤患者的全国生存率.
- 为了确定这种患者群体中死亡率的预测因素.
主要方法:
- 美国外科医生学院 - 创伤质量改善计划 (ACS-TQIP) 数据库从2017年至2020年的回顾性分析.
- 包括患有需要手术干预的肺损伤的成年创伤患者.
- 按手术类型分层 (切除,叶片切除,肺切除) 和多变量逻辑回归用于死亡率预测因素.
主要成果:
- 1.3% (2159/170,377) 的肺损伤患者接受了手术.
- 在手术治疗的患者中,整体死亡率为30%.
- 肺切除术 (54%),叶片切除术 (33%) 和切除术 (25%) 显示死亡率上升;部受伤,年龄较大以及头部/腹部受伤预测死亡率.
结论:
- 经过手术管理的创伤性肺损伤的死亡率很高 (30%).
- 手术应保留给经过精心挑选的患者.
- 同时发生的头部或腹部损伤需要谨慎的手术决策.
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