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Pulmonary Embolism II: Diagnostic Studies and Interprofessional Care01:29

Pulmonary Embolism II: Diagnostic Studies and Interprofessional Care

Diagnosing Pulmonary EmbolismDiagnosing pulmonary embolism (PE) involves clinical assessment and advanced imaging tests. The preferred diagnostic tool is the spiral (helical) CT scan or CT angiography (CTA), which uses intravenous contrast media to visualize the pulmonary vasculature and identify emboli.A ventilation-perfusion (V/Q) scan is an alternative for patients unable to receive contrast media. This scan includes both perfusion and ventilation scanning. Perfusion scanning involves...

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创伤性半皮切除术:呼吁进行初级完成.

Jan Lindahl1,2, Minna Laitinen3,4, Axel Gänsslen5

  • 1Department of Orthopaedics and Traumatology, Helsinki University Hospital, Helsinki, Finland. jan.lindahl@hus.fi.

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概括

创伤性半皮切除术 (TH) 是一种严重的骨盆损伤,需要立即,积极的损伤控制复苏. 建议在关键性缺血或神经损伤病例中优先完成TH,而不是挽救四肢.

关键词:
案例报告案例报告清算 清算 清算 清算 清算管理 管理 管理 管理创伤性半皮膜切除术 (hemiipelvectomy) 是一种创伤性半皮膜切除术.

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科学领域:

  • 创伤外科 手术 创伤外科
  • 整形外科手术 整形外科手术
  • 紧急医疗 紧急医疗

背景情况:

  • 创伤性半骨切除术 (TH) 是一种罕见的,危及生命的骨盆损伤,死亡率高.
  • 管理方面的挑战包括严重的骨盆骨折,相关的伤害和潜在的流血.
  • 现有的文献主要集中在幸存者身上,缺乏全面的治疗指南.

研究的目的:

  • 概述积极的,标准化的损害控制策略,用于管理创伤性半皮膜切除术.
  • 为手术管理提供建议,包括肢体救援与完成半皮管切除术.
  • 解决复苏,血管修复和软组织管理的关键方面.

主要方法:

  • 关于创伤性半皮膜切除术的当前文献和病例系列的综述.
  • 强调在医院前,急诊室和初始手术阶段的标准化损害控制程序.
  • 讨论大规模输血协议,血管损伤管理和结肠直肠术方面的考虑.

主要成果:

  • 积极的初步治疗对于防止脱血和污染至关重要.
  • 大规模输血协议对于管理创伤性凝血病至关重要.
  • 由于特定病例的并发症率较低和功能性结果更好 (临界缺血症,阴道结质损伤),通常偏好初级完成半端切除术而不是挽救四肢.

结论:

  • 标准化损伤控制复苏对创伤性半皮切除术患者至关重要.
  • 早期的手术干预应侧重于预防脱血和污染.
  • 建议在临界缺血和严重的阴道损伤的情况下完成半皮切除术,以改善结果.