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对急诊室腹腔切除术在患有严重腹部创伤的患者中的系统审查
Soon Tak Jeong1, Yun Chul Park2, Young Goun Jo2
1Department of Physical Medicine and Rehabilitation, Ansanhyo Hospital, Ansan City, Republic of Korea.
Scientific reports
|January 22, 2025
概括
急诊室 (ER) 腹腔切除术可以加速创伤患者的出血控制. 然而,由于研究的局限性和异质性,该系统性审查发现没有足够的证据来证实其有效性.
科学领域:
- 创伤外科 手术 创伤外科
- 紧急医疗 紧急医疗
- 手术重症监护手术重症监护
背景情况:
- 创伤性腹内出血是创伤患者死亡的主要原因.
- 传统的手术室 (OR) 腹腔切除术可能耗时,延迟了关键的干预.
- 急诊室 (ER) 腹腔切除术是一种加快治疗的替代方法.
研究的目的:
- 系统地审查ER腹腔切除术对创伤性腹内出血的疗效.
- 评估与OR腹腔切除相比,与ER腹腔切除相关的死亡率和干预时间.
主要方法:
- 从MEDLINE PubMed,EMBASE和Cochrane数据库中对研究进行系统审查,截至2024年8月9日.
- 包括10项观察性研究;使用ROBINS-I工具评估偏差风险.
- 主要结局:死亡率;次要结局:从入院到第一次腹腔切除的时间.
主要成果:
- 在ER腹腔切除术后的死亡率差异很大 (23-100%).
- 混合ER设置的死亡率 (12.7-15%) 比传统ER (21.7-22%) 低.
- 与OR腹腔切除术相比,ER腹腔切除术通常会缩短干预时间,但注意到高偏差.
结论:
- 紧急救护室腹腔切除术可能在创伤中提供更快的出血控制.
- 显著的异质性和有限的数据排除了关于ER腹腔切除术真正影响的最终结论.
- 需要进一步进行高质量的研究,以澄清ER腹腔切除术的作用.
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