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在年轻人中最佳管理形大动脉损伤
Benjamin R Zambetti1, Adam C Nelson2, Hamidreza Hosseinpour2
1Division of Vascular Surgery, University of Maryland, Baltimore, MD, USA.
American journal of surgery
|September 5, 2024
概括
动脉损伤 (BAI) 的管理因年龄而异. 患有BAI的儿童可以进行非手术治疗,而青少年受益于胸内血管大动脉修复 (TEVAR),显著降低死亡率.
科学领域:
- 创伤外科 手术 创伤外科
- 儿童心脏病学 儿童心脏病学
- 血管外科 血管外科
背景情况:
- 动脉损伤 (BAI) 是儿童和青少年罕见但严重的疾病.
- 儿科BAI的有效管理策略尚未得到充分确立.
研究的目的:
- 调查儿童群体中不大动脉损伤的管理和结果.
- 将治疗方法进行比较,并确定患有BAI的儿童和青少年死亡率的预测因素.
主要方法:
- 来自创伤质量改善计划 (TQIP) 数据库的14年分析.
- 患者 (1-19岁) 的分层分为儿童 (1-9岁) 和青少年 (10-19岁).
- 多变量逻辑回归用于确定青少年死亡预测因素.
主要成果:
- 与非手术治疗相比,接受胸内血管大动脉修复 (TEVAR) 治疗的青少年患病率相似,但死亡率明显降低 (2.1%与14.4%相比).
- TEVAR被确定为与青少年死亡率降低相关的唯一可修改的风险因素 (OR 0.138).
结论:
- 形大动脉损伤导致儿科患者的患病率和死亡率相当高.
- 非手术治疗适用于患有BAI的儿童.
- 胸内血管大动脉修复 (TEVAR) 可能会改善患有BAI的青少年的治疗结果.
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