在一级创伤中心的紧急可手术创伤性肺损伤:一项回顾性描述性研究
Lisa Osborne-Smith1,2, Barry Swerdlow1
1Nurse Anesthesia Program, Oregon Health & Science University, Portland, OR 97239, USA.
Military medicine
|September 19, 2024
概括
紧急可操作的肺创伤 (EOPT) 手术,通常是由于出血,最常见的治疗是腹腔切除术用于腹膜修复. 手术的时间缩短和初始输管改善了创伤患者的生存率.
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
- 手术重症监护手术重症监护
背景情况:
- 紧急可操作的肺创伤 (EOPT) 具有显著的战场发病率和死亡率.
- 民用EOPT与军事EOPT共享介绍,管理和结果.
- 了解民用EOPT有助于战场EOPT管理和分类.
研究的目的:
- 描述性地分析EOPT的性质和管理.
- 为了确定 EOPT 患者因子和结果之间的关联.
- 通过民用数据为战场EOPT战略提供信息.
主要方法:
- 在一级创伤中心从2012年到2020年对EOPT病例的回顾性分析.
- 包括106名患者,不包括初级心脏创伤.
- 对创伤登记册和电子病历进行数据和统计分析的审查.
主要成果:
- 住院死亡率为17.0%.
- 单侧腹膜撕裂是最常见的损伤 (62.3%).
- 腹膜修复的腹膜切除术是最常见的手术 (71.7%).
- 无法控制的出血是EOPT手术的首要指示.
- 一个肺通风 (OLV) 很少使用 (8.5%).
- 手术室到达的时间较短和初始内内输管与生存有关.
结论:
- 失控的出血导致了EOPT手术,经常需要腹腔切除术来修复腹膜.
- 很少使用OLV (91.5%没有OLV) 是值得注意的.
- 广泛的伤害,医院前输管和延迟的手术增加了死亡风险.
- 民用EOPT数据为战场创伤管理和患者分拣提供了洞察力.
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