创伤患者气管切除术的流行病学,时间,技术和结果:多中心回顾性研究
Soon Ki Min1, Jin Young Lee2, Seung Hwan Lee1,3
1Department of Trauma Surgery, Gachon University Gil Medical Centre, Incheon, Republic of Korea.
ANZ journal of surgery
|December 26, 2024
概括
创伤患者的早期气管切除术显著减少了住院时间和机械通风持续时间. 这项研究强调了及时干预对改善患者结果和更快恢复的好处.
科学领域:
- 创伤外科手术是什么
- 关键护理医学 关键护理医学
- 呼吸道管理 呼吸道管理
背景情况:
- 气管切除术对于创伤患者的长时间通风至关重要.
- 虽然有好处,但气管切除术具有固有的风险.
- 最佳时机,技术和患者选择仍然是需要研究的领域.
研究的目的:
- 调查早期与晚期气管切除术对创伤患者临床结果的影响.
- 通过皮肤扩张气管切除术 (PDT) 和手术气管切除术 (ST) 之间的结果进行比较.
- 确定影响住院和ICU停留时间的因素,以及无呼吸器的日子.
主要方法:
- 对220名接受气管切除术的成年创伤患者的回顾性分析.
- 早期 (≤10天) 与晚期 (>10天) 气管切除组的比较.
- PDT与ST技术的比较.
- 多重线性回归以确定影响停留时间和通风持续时间的因素.
主要成果:
- 大多数气管切除术是晚期进行的 (61.4%),主要是通过PDT.
- 早期气管切除术 (38.6%) 更频繁地使用ST进行.
- 早期气管切除术显著减少了住院和重症监护室的住院时间,机械通风的持续时间,增加了无呼吸器的日数.
- 没有观察到无需ICU的日数或住院死亡率的显著差异.
结论:
- 创伤患者的早期气管切除术与更短的住院和ICU住院有关.
- 及时的气管切除术会导致机械通风持续时间的减少和无呼吸器日数的增加.
- 这些发现支持考虑在符合条件的创伤患者中提前进行气管切除术,以改善资源利用和患者康复.
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