患有创伤性腹部固体器官损伤的儿科患者非手术治疗失败的患病率:系统性审查和元分析
Lorenzo Gamberini1, Federico Moro1, Silvia Cavagna1
1Department of Anesthesia, Intensive Care and Prehospital Emergency, Ospedale Maggiore Carlo Alberto Pizzardi, Bologna, Italy.
Injury
|July 19, 2025
概括
在儿科腹部固体器官创伤中,非手术性管理 (NOM) 的失败不常见 (4%),年幼儿童的成功率更高. 由于潜在的并发症和错过的伤害,仔细监测至关重要.
科学领域:
- 儿科手术 儿科手术
- 创伤管理 创伤管理
- 器官受伤器官受伤器官受伤器官受伤器官
背景情况:
- 儿童的腹部固体器官 (ASO) 创伤,影响脏,脏和肝脏,提出了临床挑战.
- 对于稳定的患者来说,非手术治疗 (NOM) 是首选的,但失败可能导致严重出血.
- 手术干预可能会导致慢性器官功能障碍和并发症.
研究的目的:
- 为了确定患有创伤性ASO伤害的儿科患者中NOM失败的患病率.
- 在这个人群中确定与NOM失败相关的预测因素.
主要方法:
- 在PubMed,Scopus和Cochrane图书馆进行系统的文献搜索,直到2024年8月.
- 比例元分析以估计聚合的NOM失败患病率.
- 超回归和多模型推断来评估预测因素的重要性.
主要成果:
- 分析了67项涉及37340名儿童的研究.
- 诺姆失败的综合流行率为4% (95% CI: 3-6%).
- 较高的伤害严重性评分 (ISS),AAST等级和年龄与增加的NOM失败有关.
结论:
- 儿童创伤性ASO损伤中的NOM失败并不常见,器官挽救率很高.
- 年龄较小的孩子表现出更好的NOM成功,支持保守的方法.
- 并发症率 (9%) 和遗漏伤害率 (3%) 是不可忽视的,因此需要密切监测.
相关概念视频
Esophageal Perforation-II: Clinical Manifestations and Management
150
Esophageal perforations manifest in various clinical forms, influenced by factors such as the perforation's cause and location (cervical, intrathoracic, or intra-abdominal), the extent of contamination, and potential injury to adjacent mediastinal structures. The timing between the perforation occurrence and treatment initiation also affects the clinical presentation.
Clinical Manifestations:
Clinical Manifestations:
150
Appendicitis-II: Diagnostic Studies and Management
145
Diagnosing and managing appendicitis requires a structured and comprehensive approach that spans from initial assessment to postoperative care. Here is an overview of the process:
Diagnosing Appendicitis
It requires a multifaceted approach, starting with a detailed physical examination to pinpoint the location and nature of the pain and identify any associated symptoms. Laboratory tests play a crucial role. A complete Blood Count (CBC) typically reveals leukocytosis (an increased number of...
Diagnosing Appendicitis
It requires a multifaceted approach, starting with a detailed physical examination to pinpoint the location and nature of the pain and identify any associated symptoms. Laboratory tests play a crucial role. A complete Blood Count (CBC) typically reveals leukocytosis (an increased number of...
145
Aneurysm III: Interprofessional Care
28
Aneurysm management involves either conservative medical therapy or surgical intervention, depending on the size and symptoms of the aneurysm. Conservative management is generally reserved for smaller, asymptomatic aneurysms, while larger or symptomatic aneurysms often necessitate surgical repair.Conservative Medical TherapyFor small, asymptomatic aneurysms, particularly abdominal aortic aneurysms (AAA) less than 5.5 centimeters in diameter, conservative medical therapy is recommended. This...
28
Urinary Tract Calculi VI: Surgical Management
30
Procedures for Kidney StonesMedical intervention is necessary when kidney stones or renal calculi are too large to pass spontaneously (typically greater than 5 millimeters) when stones are accompanied by symptomatic infection (such as fever or pyelonephritis), when they impair kidney function, or when they cause persistent symptoms like severe pain, nausea, or urinary retention. Additionally, patients with only one kidney or those who cannot be treated with medical management also require...
30
Aneurysm IV: Nursing Management
20
Vigilant monitoring for aneurysm rupture is essential for patients undergoing aortic surgery.Preoperative Nursing ManagementContinuously monitor the patient for manifestations of aneurysm rupture, such as pallor, weakness, tachycardia, hypotension, abdominal, back, groin, or periumbilical pain, changes in consciousness, and a pulsating abdominal mass. Regularly assess the patient's peripheral pulses.Instruct the patient to consume a clear liquid diet the day before surgery and administer...
20
Peptic Ulcer Disease V: Surgical Management and Nursing Care
412
Surgical management and nursing care are crucial in treating Peptic Ulcer Disease (PUD). Here is an organized and enhanced overview of the surgical interventions and the associated nursing care for PUD:
Surgical Interventions for Peptic Ulcer Disease
Surgical Interventions for Peptic Ulcer Disease
412


