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对主动脉复苏性内血管气球闭塞的基于共识的指示:日本的综合调查和描述性数据库研究

Toshinao Suzuki¹, Atsushi Shiraishi², Akira Endo³

¹Department of Anesthesiology, Kimitsu Chuo Hospital, Chiba, Japan.

|July 15, 2025

概括

主动脉内血管气球阻塞 (REBOA) 用于创伤,但需要明确说明. 这项研究确定了适当的REBOA用途,并发现使用不当时死亡率更高.

科学领域:

创伤外科手术创伤外科
紧急医疗紧急医疗
血管外科血管外科

背景情况:

复苏性内血管气球阻塞大动脉 (REBOA) 是创伤诱导出血的新兴辅助策略.
关于在创伤患者中使用REBOA的适当指示存在缺乏共识.
这项研究的目的是建立基于共识的REBOA指示,并根据这些指示评估结果.

研究的目的:

在创伤专家之间定义基于共识的REBOA的适当指示.
调查与REBOA使用相关的患者特征和结果,比较适当的与不适当的适应症.
分析接受REBOA的创伤患者的死亡率和并发症.

主要方法:

一次重复的Delphi调查涉及11名创伤专家,使用来自日本创伤数据库 (JTDB) 的42个定义的静血程序进行.
根据Delphi调查的共识,接受REBOA的患者被分为"适当"和"不适当"的指示组.
进行了基线特征,时间指标 (门到血液静止,门到血液输血),死亡率 (急诊室和住院) 和并发症的比较分析.

主要成果:

达成共识,将腹内,背,骨盆和四肢出血定义为REBOA.的适当指示.
在JTDB的1833名REBOA患者中,1077人有适当的,756人有不适当的指示.
不适当的指示与明显更高的原始住院死亡率 (72.9%与57.6%) 和急诊室死亡率 (38.6%与15.4%) 相关.

结论:

在研究队列中,超过40%的REBOA应用超出了已确定的适当指示.
接受REBOA治疗不合适适应症的患者的死亡率较高.
需要进一步的研究来澄清特定的静血程序与REBOA结果之间的关联.

关键词:

德尔菲的方法方法德尔菲方法.描述性研究是一种描述性研究.标志标志表示标志复苏性内血管气球阻塞大动脉 (REBOA)创伤登记册中的创伤记录.

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