在最初不稳定的胸腔腹部创伤中,计算机断层扫描可以安全地增强分拣
Anna White1, Lindsey Loss2, John Carney3
1Division of Acute Care Surgery, University of Nebraska Medical Center, USA.
Surgery in practice and science
|March 3, 2025
概括
血动力学上异常的创伤患者有改善的血压可以在手术前安全地接受计算机断层扫描 (CT). 这种方法并没有增加住院时间或死亡率,也没有减少输血.
科学领域:
- 创伤外科 手术 创伤外科
- 紧急医疗 紧急医疗
- 放射学 放射学是一门学科.
背景情况:
- 计算机断层扫描 (CT) 在血液动力学不稳定的创伤患者的使用是有争议的.
- 在成像之前,经常采用积极的复苏.
研究的目的:
- 为了研究血液动力学上异常的胸腔腹部创伤患者在最终治疗之前接受CT的结果.
- 评估CT成像在这个患者群体中的安全性和有效性.
主要方法:
- 血动力学异常患者 (HR≥120 bpm,SBP<90 mmHg) 胸腔腹部创伤的回顾性审查.
- 包括在复苏后实现了血液动力学改善 (SBP≥90 mmHg) 的患者.
- 对CT和直接到OR组的匹配,以确定受伤严重程度和操作细节.
主要成果:
- 两组之间的住院时间,ICU住院时间,呼吸机日或死亡率没有显著差异.
- 接受CT的患者需要更少的包装红细胞 (PRBC) 和新鲜冷血 (FFP) 输血.
- 直接到OR的群体更有可能需要额外的程序.
结论:
- 血动力学上异常的胸腔腹部创伤患者在复苏后血压至少为90mmHg时,可以安全地接受CT.
- 在最终治疗之前的CT成像可能与减少输血需求和更少的额外手术有关.
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