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REBOA或复苏胸腔切除术,对于不同患者来说是不同的工具. 来自AORTA注册表的现实生活分析

Federico Coccolini¹, Marco Ceresoli², Gabriella Licitra³

¹General, Emergency and Trauma Surgery Department, Pisa University Hospital, Pisa, Italy.

|July 23, 2025

概括

复苏性内血管气球阻塞大动脉 (REBOA) 用于老年重创伤患者,而复苏性胸腔切除术 (RT) 在透创伤病例中更为常见. 患者因素和医院的特点影响了这些大动脉封闭技术之间的选择.

科学领域:

创伤外科手术创伤外科
紧急医疗紧急医疗
心血管干预心血管干预

背景情况:

关于大动脉封闭 (AO) 技术存在争议,特别是重伤患者的复苏性内血管气球封闭大动脉 (REBOA) 与复苏性胸腔切除术 (RT).
了解影响REBOA和RT之间选择的不同患者状况和机构因素对于优化创伤护理至关重要.

研究的目的:

根据患者特征和临床表现,识别和评估使用AO技术 (REBOA与RT) 的差异.
为了在多中心创伤注册中比较接受REBOA和RT的患者群体.

主要方法:

一项比较的多中心注册研究分析了2013年10月至2022年2月的数据,重点关注伤后大动脉封闭.
成年创伤患者 (≥16岁) 在急诊室接受REBOA (区域1) 或RT进行了比较.
从创伤和急性护理手术 (AORTA) 中复苏的大动脉封闭记录 (AORTA) 的数据被利用.

主要成果:

在25.9%的患者中使用REBOA,而在74.1%的患者中使用RT.
REBOA患者年龄较大,更频繁地受到重创伤,并呈现出较高的缩血压和格拉斯哥昏迷表得分.
穿透创伤,伤害严重性得分 (ISS) 较低的患者,以及每年创伤入院人数较少的设施中,RT更常见.

结论:

在接受REBOA和RT治疗的患者之间,患者人口统计学,损伤模式和生理状况存在显著差异.
机构因素,如每年创伤病例数量,也与选择AO技术相关.
需要进一步的研究来阐明在严重创伤中对REBOA和RT的最佳患者选择标准.

关键词:

疾病发病率疾病发病率死亡率死亡率死亡率这就是REBOAA.进行复苏性胸腔切除术 (resuscitative thoracotomy).

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