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对当代战时血管损伤的初步评估
Victor Bilman1, Abebe Tiruneh2, Daniel Silverberg1
1The Department of Vascular Surgery, The Chaim Sheba Medical Center, Tel-HaShomer, Ramat Gan, Israel; Faculty of Medical and Health Sciences, Tel Aviv University, Israel.
概括
在现代战争中,血管创伤带来了重大风险. 高伤害严重性得分,入院时的冲击和胸部血管损伤增加了死亡率,而下肢骨折预测了士兵的截肢.
科学领域:
- 军事医学 军事医学
- 血管外科 血管外科
- 创伤外科 手术 创伤外科
背景情况:
- 军事冲突产生复杂的血管创伤,在外科手术管理方面提出了挑战.
- 血管外科的进步改善了战时受伤的治疗结果.
研究的目的:
- 为了评估来自最近冲突的士兵的血管损伤模式.
- 为了确定血管创伤后死亡和截肢的关键风险因素.
主要方法:
- 使用国家创伤登记数据对患有血管损伤的住院士兵进行了回顾性分析.
- 后勤回归分析以确定主要截肢和死亡的风险因素.
- 该研究遵循STROBE (加强流行病学观察性研究报告) 的指导方针.
主要成果:
- 179名士兵 (9.0%) 患有218种血管损伤,最常见的是下肢损伤 (51.4%).
- 第二次截肢发生在5.6%的病例中,整体死亡率为8.9%.
- 死亡的危险因素包括高伤害严重性得分,休克 (静缩血压<90 mmHg) 和胸部血管损伤. 下肢骨折预测了二次截肢.
结论:
- 现代战争中的血管损伤具有不同的模式和危险因素.
- 胸部血管损伤,冲击和高伤害严重性得分与增加的死亡率有关.
- 下肢骨折是二次截肢的重要预测因素.
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