创伤性血胸的胸部灌:一个系统的审查和元分析
Nicole B Lyons1, Brianna L Collie, Michael D Cobler-Lichter
1From the Divisions of Trauma, Surgical Critical Care, and Burns, DeWitt Daughtry Family Department of Surgery, Ryder Trauma Center, University of Miami Miller School of Medicine, Miami, Florida.
The journal of trauma and acute care surgery
|November 7, 2024
概括
对于创伤性血胸 (HTX) 的管胸切除术 (TT) 期间的胸部灌显著减少保留的HTX,需要重新干预. 这一元分析表明,灌是最初创伤管理的有益补充.
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:
- 创伤性血胸 (HTX) 是一种常见的伤害,最初通过管胸切除术 (TT) 进行管理.
- 保留的HTX可能会导致像纤维胸部或瘤这样的并发症,需要进一步的干预.
- 假设在TT插入期间灌胸腔可能会防止保留的HTX.
研究的目的:
- 评估管胸切除术时胸部灌的有效性,以预防保留的血胸.
- 为了比较灌与非灌TT的患者之间的失败率和二次干预需求.
主要方法:
- 对2024年5月之前发表的研究进行了系统审查和元分析.
- 包括的研究涉及成年创伤患者,创伤性HTX接受TT治疗,比较那些接受胸部灌的人.
- 主要结局是失败率 (保留的HTX需要二次干预);进行了累积和元分析.
主要成果:
- 分析了6项涉及1319名患者的研究 (513名灌TT,837名非灌TT).
- 在灌组中,失败率明显较低 (10.7%与18.2%,p < 0.001).
- 灌的TT与较短的TT持续时间,住院和ICU停留时间 (p <0.05) 相关,感染并发症或死亡率没有增加.
结论:
- 对于创伤性HTX,同时进行胸部灌和TT插入与保留血胸的减少率有关.
- 胸部灌应该被认为是创伤性HTX的TT的辅助.
- 建议进一步进行随机对照试验,以建立最终的指导方针.
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