突发创伤的急救中心胸腔切除术:来自南非两个地区级急救中心的见解
Johann Christian Sittmann1, Ferhana Gool2, Candice Van Koningsbruggen3
1Division of Emergency Medicine, University of Cape Town, Cape Town, South Africa.
Injury
|December 28, 2024
概括
南非紧急中心胸切除术 (ECT) 的生存率为24%,相当于国际数据. 这项研究突出了ECT在资源有限的环境中对极端创伤患者的潜力.
科学领域:
- 创伤外科 手术 创伤外科
- 紧急医疗 紧急医疗
- 全球健康 全球健康
背景情况:
- 创伤严重导致全球疾病负担,特别是在低收入和中等收入国家.
- 紧急中心胸切除术 (ECT) 是严重受伤的创伤患者的关键干预.
- 关于ECT的现有文献主要来自高收入国家.
研究的目的:
- 描述患者的人口统计学,伤害模式和在南非资源有限的环境中进行ECT的程序细节.
- 在这个特定的背景下评估ECT的成果.
主要方法:
- 在两个地区级设施的急诊中心 (EC) 进行创伤后胸切除术的患者的回顾性图表审查.
- 数据收集时间从2017年4月到2021年3月.
- 纳入标准侧重于EC胸切除术;排除标准包括非EC胸切除术或缺失记录.
主要成果:
- 在4年内进行了67次心电测试,主要用于刺伤 (50) 和枪伤 (17),没有突击创伤的病例.
- 大多数患者都是年轻的男性,呈现出生命迹象,并且经常自行运输.
- 整体存活率到出院为24% (刺伤为32%,枪伤为0%);在幸存者中,神经学结果似乎有利.
结论:
- 在资源有限的地区环境中进行的ECT,随后转移到第三级护理,可能会产生与国际上报告的生存率相当或超过的生存率.
- 需要进一步的研究,包括前性研究,以完善理解并制定类似环境中ECT的当地指南.
- 在这个研究地点,创伤和ECT手术的高发病率为未来的研究提供了宝贵的机会.
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