创伤患者的诊断性腹腔镜:我们是否需要打开,看看我们是否可以在不打开的情况下看到?
Kati Hage1, Adam Nelson1, Muhammad Haris Khurshid1
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
|September 17, 2024
概括
诊断性腹腔镜 (DL) 为稳定的创伤患者提供了更好的结果,与非治疗性腹腔镜 (NL) 相比,减少了死亡率和并发症. 这种微创的方法可以改善患者的康复和住院时间.
科学领域:
- 创伤外科 手术 创伤外科
- 最少侵入性的手术
- 外科手术的结果
背景情况:
- 诊断性腹腔镜 (DL) 建议在稳定的创伤患者中减少非治疗性腹腔切除术 (NL).
- 这项研究比较了血液动力稳定的创伤患者中DL和NL之间的结果.
研究的目的:
- 评估诊断性腹腔镜与非治疗性腹腔切除术在血液动力学稳定的创伤患者中的比较有效性.
- 评估外科手术对死亡率,并发症和住院时间的影响.
主要方法:
- 美国外科医生学院创伤质量改善计划 (2017-2020年) 的回顾性分析.
- 包括血液动力学稳定的成人创伤患者,接受DL或NL.
- 根据损伤机制进行分层 (不或穿透) 以进行比较分析.
主要成果:
- DL与显著降低死亡率 (aOR 0.10) 和重大并发症 (aOR 0.38) 的几率有关.
- 接受DL治疗的患者在医院停留时间较短 (β-1.22).
- 随着DL的改善结果在不的和透的伤害子组中一致.
结论:
- 与非治疗性腹腔镜相比,诊断性腹腔镜在血液动力学稳定的创伤患者中提供了更好的结果.
- 至少侵入性技术的进步使得避免不必要的探索性腹腔切除术,提高了患者的护理.
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