下腔静脉损伤:我们正在做我们真正必须做的事情吗?
Rodrigo Barros De Carvalho1, Laisa Simakawa Jimenez2, Renato Nardi Pedro2
1Division of Trauma, Department of Surgery, Campinas University Faculty of Medicine, Campinas, Brazil.
下腔静脉 (IVC) 损伤尽管在创伤护理方面取得了进展,但仍然具有极高的致命性. 坚持均衡的复苏和损伤控制手术 (DCS) 对于改善IVC创伤患者的治疗结果至关重要.
科学领域:
- 创伤外科 手术 创伤外科
- 血管外科 血管外科
- 手术重症监护手术重症监护
背景情况:
- 下腔静脉 (IVC) 损伤很常见,并与高死亡率相关.
- 尽管在复苏方面取得了进展,但IVC损伤的死亡率并没有相应地改善.
- 对IVC损伤死亡率的预测因素需要进一步调查.
研究的目的:
- 为了确定IVC损伤患者的死亡率预测因素.
- 评估平衡复苏和损伤控制手术 (DCS) 对结果的影响.
- 将机构成果与现有文献进行比较.
主要方法:
- 创伤患者数据库记录的回顾性分析.
- 包括从1990年1月到2017年8月确认IVC损伤的患者.
- 强调识别死亡率预测因素和治疗策略.
主要成果:
- 确定了74名IVC受伤的患者;87.8%的穿透创伤 (76.3%的枪击).
- 总体死亡率为52.7%; 下损伤为39.2%.
- 损伤控制手术 (DCS) 在33.8%的病例中使用,死亡率为68%.
结论:
- 对冲击复苏的全面理解是必不可少的.
- 创伤护理专业人员必须确保一致应用平衡复苏和DCS.
- 改进这些策略的应用可能会降低IVC损伤死亡率.
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