对肋骨骨折进行手术固定与保守治疗的临床结果分析:系统性评估和元分析
Penglong Zhao1, Qiyue Ge2, Haotian Zheng2
1Department of Cardiothoracic Surgery, Jinling Clinical Medical College, Nanjing University of Chinese Medicine, Nanjing, China.
World journal of emergency surgery : WJES
|February 5, 2025
概括
肋骨骨折的手术稳定 (SSRF) 减少了多重肋骨骨折的成年患者的死亡率. 对于胸部或60岁以上的人来说,它特别有益,但仔细选择患者是关键.
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:
- 对肋骨骨折进行手术稳定 (SSRF) 的采用增加了,尽管对其有效性的争论.
- 对于多重创伤性肋骨骨折的SSRF与保守管理的有效性需要进一步调查.
研究的目的:
- 系统地审查和对20年来文献进行元分析.
- 为了比较经过SSRF和保守治疗的多重创伤性肋骨骨折的成年患者的临床结果.
主要方法:
- 在六个数据库中搜索了2004年6月至2024年6月的研究.
- 使用RoB 2和NOS工具评估研究质量.
- 计算的相对风险 (RR) 与95%的置信区间 (CI) 对于包括死亡率,HLOS,ILOS,DMV和肺炎发病率在内的结果.
主要成果:
- 包括47项研究,包括1,078,795名患者.
- 与保守治疗相比,SSRF显示所有原因死亡率有所改善.
- 在HLOS,ILOS或医疗保健费用方面没有显著差异;然而,SSRF降低了肺炎发病率和DMV在胸患者和60岁以上的患者中.
结论:
- 在多重肋骨骨折患者中,SSRF可降低死亡率,特别是那些胸部有裂纹或60岁以上的患者.
- 早期的SSRF (72小时内) 可能会降低HLOS和DMV.
- 谨慎的患者选择对于最大限度地提高SSRF的好处至关重要.
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