不必要地接受治疗:医院前针切胸术的评估
Gabriel E Vazquez1, John R Calhoun, Elizabeth A Fuchsen
1Author Affiliations: Iowa Methodist Medical Center, UnityPoint Health, Des Moines, IA (Mr Vazquez, Dr Calhoun, Ms Fuchsen, and Drs Capella, Vaudt, Sidwell, Smith, Pelaez); University of Iowa Roy J and Lucille A Carver College of Medicine, Iowa City, IA (Mr Vazquez); and The Iowa Clinic, Des Moines, IA (Drs Capella, Dr Sidwell and Dr Pelaez).
医院前针胸口切除可能被过度使用,有效性和并发症的可能性的证据有限. 遵守指南对于在张力肺胸病例中适当使用至关重要.
科学领域:
- 紧急医疗 紧急医疗
- 创伤外科 手术 创伤外科
- 关键的护理关键的护理
背景情况:
- 针胸切除术是紧张性肺胸部的一个关键干预.
- 这种程序的潜在过度使用可能会导致患者的发病率增加.
研究的目的:
- 评估医院前针切胸术的指示,有效性和不良结果.
- 评估是否遵守注射针减压的既定指南.
主要方法:
- 对接受医院前针切胸术的患者进行了回顾性队列研究.
- 从一级创伤中心登记处分析了超过7.5年的数据.
- 主要结局包括正确的指示和生命体征改善;次要结局评估并发症和存活率.
主要成果:
- 在63项手术中,只有4名患者满足了所有三个创伤生命支持标准.
- 在手术后没有观察到任何显著的医院前生命体征变化.
- 图像检查显示并发症包括肺部破伤 (28%),肺胸部 (11%),以及针位置不正确 (28%在胸外,5%在腹部).
结论:
- 证据表明,可能会过度使用和相关的发病率与医院前针胸腔切除术.
- 建议严格遵守特殊的指导方针减压的指导方针.
- 需要进一步的研究来优化患者选择和程序结果.
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