肋管胸腔切除术后输出对胸部再干预的需要的影响:体积是否重要?
Negaar Aryan1, Jeffry Nahmias1, Areg Grigorian1
1University of California, Irvine, Department of Surgery, Division of Trauma, Burns and Surgical Critical Care.
Injury
|October 9, 2024
概括
用管胸切除术 (SSRF+TT) 进行肋骨骨折的手术稳定没有显示出胸管输出和重新干预需求之间的联系. 超过17%的患者需要重新干预,无论在切除胸腔管之前是否有液体排水.
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
- 关键护理医学 关键护理医学
背景情况:
- 肋骨骨折的手术稳定 (SSRF) 改善了结果.
- 管胸切除术 (TT) 在SSRF中很常见,但切除的最佳时间尚不清楚.
- 胸部重新干预 (例如,重新输管,重新插入TT) 是潜在的并发症.
研究的目的:
- 为了在接受SSRF+TT的患者中比较胸部再干预.
- 要确定在删除前的TT输出是否预测需要重新干预.
- 为了确定与SSRF+TT后的胸部再干预相关的因素.
主要方法:
- 从2018年到2023年对133名重创伤患者 (≥18岁) 的回顾性分析.
- 对比了需要胸部再干预的患者与没有需要胸部再干预的患者.
- 作为二次结果,分析了删除前的TT持续时间和输出.
主要成果:
- 17.3%的患者 (23/133) 需要进行胸部再干预.
- 重复干预组的伤害严重程度得分更高 (中位数为29比17),TT持续时间更长 (中位数为4比3天).
- 两组之间TT输出没有显著差异 (SSRF后的第一天或提取前24小时内).
结论:
- 超过17%的接受SSRF+TT治疗的患者需要进行胸部再干预.
- 在切除前的胸管输出与重新干预的需要无关.
- 对于TT输出的绝对值不应指导SSRF后的删除时间.
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