在第三级急诊室对刺伤伤害的评估:一项追溯观察性研究
Nil Deniz Kartal Yeter1, Mehmet Ali Karaca2, Ahmet Sefa Yeter3
1Vocational School of Health Services, First and Emergency Aid Program, Hacettepe University, Ankara, Turkey. nildekarster@gmail.com.
BMC emergency medicine
|September 16, 2024
概括
肢体的刺伤很常见,但严重的伤害往往会影响胸部和腹部. 早期CT扫描对于诊断关键胸腔腹部刺伤和改善生存结果至关重要.
科学领域:
- 紧急医疗 紧急医疗
- 创伤外科 手术 创伤外科
- 法医病理学 法医病理学
背景情况:
- 蓄意的暴力,包括刺伤攻击,在2021年造成4.58万人的死亡,刺伤占杀人案的25%.
- 刺伤是严重的公共卫生问题,需要对伤害模式和结果有充分的了解.
研究的目的:
- 评估伤害模式,创伤分数,放射学发现,治疗方法和刺伤后的患者结果.
- 确定与刺伤受害者的严重伤害和死亡率相关的因素.
主要方法:
- 进行了一项追溯观察性研究,该研究对在刺伤后被送往第三级急诊室 (ED) 的患者进行了观察.
- 收集的数据包括受伤地点和模式,放射学发现,治疗,咨询,并发症,创伤得分 (RTS,ISS) 和结果 (手术,住院,死亡率).
主要成果:
- 在648名患者中,87%是男性,平均年龄为28岁. 常见的伤害是四肢 (75%),胸部 (21.9%) 和腹部 (16.9%).
- 严重和致命的伤害主要涉及胸部和腹部. 计算机断层扫描 (CT) 发现了比FAST扫描更严重的伤害.
- 死亡率为1.5% (10名患者). 下格拉斯哥昏迷量表 (GCS),修订创伤评分 (RTS) 和生存概率 (Ps),以及较高的伤害严重程度评分 (ISS) 与增加的死亡率和红细胞替代需要有关.
结论:
- 虽然四肢受伤最常见,但胸腔腹部刺伤带有更高的严重和致命结果的风险.
- 早期胸部和腹部CT成像推用于胸腔腹部刺伤,以确保及时诊断和管理.
- 较低的GCS,RTS和Ps,以及较高的ISS,是严重损伤的指标,并预测需要红细胞替代.
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