由于外周损伤而流血的创伤患者可能可以通过停止出血技术来挽救
John Culhane1, Raymond Okeke1, Timothy Corpuz1
1Center for Specialized Medicine, St. Louis University School of Medicine, SSM Health St. Louis University Hospital, St. Louis, MO, USA.
Journal of emergencies, trauma, and shock
|September 26, 2025
概括
创伤导致的外部出血仍然是可预防死亡的原因之一. 公众对血液控制技术的教育,比如美国外科医生学院停止出血 (STB) 计划中的那些,可以通过解决可压缩伤害来挽救生命.
科学领域:
- 创伤外科 手术 创伤外科
- 公共卫生 公共卫生
- 紧急医疗 紧急医疗
背景情况:
- 创伤引起的外出出血,特别是因结节或外周损伤引起的外出血,是可预防死亡的重要原因之一.
- 虽然许多外围损伤是可压缩和可用现场技术控制的,但死于四肢和结节出血的死亡仍然存在.
- 美国外科医生学院停止出血 (STB) 计划旨在赋予公众在创伤现场的出血控制技能.
研究的目的:
- 量化创伤死亡率,可以通过实施STB技术来预防.
- 在六年内分析远端肢体外流血损伤的发病率和死亡率.
主要方法:
- 来自一级创伤中心和国家创伤数据库 (NTDB) 的创伤患者的回顾性病例系列分析.
- 将伤害分为不可压缩,可能压缩和绝对压缩的类别.
- 评估2017年至2022年间孤立远端四肢损伤发生率和死亡率的变化.
主要成果:
- 在当地数据中,1.73%的早期创伤死亡是由于被认为可压缩的伤害造成的.
- 在全国范围内 (NTDB),0.4%的总死亡被归因于孤立的压缩性损伤,代表了可能通过STB技术挽救的患者.
- 在研究期间,由于孤立的远端四肢损伤而导致的死亡率略有但显著增加,但发病率没有显著变化.
结论:
- 外部出血导致的脱血仍然是全国创伤护理的关键问题.
- 持续发生的死亡事件凸显了对控制出血的公共教育的持续需求.
- 广泛采用STB技术可能会减少可预防的外部出血死亡.
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