在初始胸部X射线上创伤性肺胸部的大小独立地与儿童的失败观察有关
Shruthi Srinivas1, Brenna Rachwal, Katherine C Bergus
1From the Department of Pediatric Surgery (S.Srinivas, B.R., K.C.B., T.A., K.V.A., R.T., D.S.), and Department of Radiology (A.A., E.K., S.Shah), Nationwide Children's Hospital; and Department of Surgery (J.R.C.), Division of Trauma, Critical Care, and Burn, The Ohio State University, Columbus, Ohio.
儿童的创伤性肺胸 (tPTX) 通常可以通过观察来管理. 然而,胸部X射线尺寸为12.5%或更大,表明观察失败的风险更高,这表明可能需要管胸切除术.
科学领域:
- 儿科创伤学 儿科创伤学
- 胸部外科手术 胸部外科手术
- 放射学 放射学是一门学科.
背景情况:
- 在儿童中,创伤性肺胸 (tPTX) 通常用管胸切除术 (TT) 治疗.
- 对TT的必要性与对tPTX的观察需要进一步调查.
- 最初的胸部X射线 (CXR) 尺寸可以预测治疗结果.
研究的目的:
- 要确定初始CXR上的tPTX大小是否与需要TT相关.
- 确定初始tPTX大小是否预测没有TT的观测失败.
主要方法:
- 在一级创伤中心 (2010-2023) 接受tPTX的儿科患者 (≤18岁) 的回顾性评估.
- 用于估计CXR上的tPTX大小的体积计柯林斯方法.
- 分析包括接收机运行特征曲线和多变量回归.
主要成果:
- 在313名患有tPTX的儿童中,有45名 (13.5%) 失败了需要TT的观察.
- 较大的tPTX大小 (≥12.5%) 与观察失败独立相关.
- 与失败相关的因素包括低血压,血肺胸部和机械通风.
结论:
- 在CXR上,柯林斯大小≥12.5%是儿科tPTX失败观察的独立预测指标.
- 对具有较小tPTX的儿童来说,观察可能是一种安全有效的策略.
- 这一发现可以指导关于儿科tPTX管理的临床决策.
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