在创伤性脑损伤中,部分:全相对部分内血管大动脉阻塞的力量
Bhairav Shah1, Emily W Rady1, Michael Lieber1
1Department of Trauma Surgery, OhioHealth Grant Medical Center, Columbus, Ohio.
The Journal of surgical research
|June 28, 2025
概括
在创伤性脑损伤 (TBI) 的创伤患者中,部分大动脉封闭 (PO) 允许更好地控制血压,并减少ARDS等并发症. 然而,与完全封闭 (FO) 相比,它不会影响整体生存率.
科学领域:
- 创伤外科 手术 创伤外科
- 神经外科 神经外科
- 关键护理医学 关键护理医学
背景情况:
- 复苏性内血管气球阻塞大动脉 (REBOA) 用于创伤患者的出血控制.
- 许多需要REBOA的创伤患者也患有创伤性脑损伤 (TBI),这种组合与高死亡率有关.
- 血管内大动脉封闭 (EAO) 可以使用完全封闭 (FO) 或部分封闭 (PO) 进行,在TBI患者中对它们的比较作用的数据有限.
研究的目的:
- 评估FO和POEAO模式与TBI患者的结果之间的关联.
- 为了比较FO与PO在达到缩血压 (SBP) 目标和减少TBI中二次侮辱的有效性.
主要方法:
- 在创伤和急性护理外科注册中对复苏的AAST大动脉封闭的回顾性分析.
- 包括重创伤患者,缩略伤害量表头≥1,接受EAO.
- 对FO和PO组之间的结果进行比较,重点关注SBP目标的实现,死亡率和次要并发症.
主要成果:
- 分析了147名患者 (97名FO,50名PO),没有显著的人口差异.
- PO组显示血小板和晶状体输血显著减少.
- 经过PO的严重TBI患者更频繁地达到SBP目标 (83%与57.1%相比);FO与急性呼吸困扰综合征 (ARDS) 的更高率有关.
结论:
- 部分大动脉封闭 (PO) 促进了更好的SBP定位,可能减少TBI患者的二次脑损伤.
- 与FO相比,PO与ARDS的发病率降低有关.
- EAO类型 (FO与PO) 在TBI患者的死亡率中没有显著差异.
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