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地平面下降,你打电话给谁? 适当的创伤对于地面的落在抗凝剂上
Avi Bhavaraju1, Krista Stephenson2, Lawrence VanDyke3
1Division of Acute Care Surgery, Department of General Surgery, University of Arkansas for Medical Sciences, Little Rock, Arkansas.
The Journal of surgical research
|October 5, 2025
概括
对抗凝血药患者的修订创伤激活标准没有减少对内出血的干预时间. 更有选择性的方法可以优化对低能量的创伤病例的资源.
科学领域:
- 创伤外科 手术 创伤外科
- 紧急医疗 紧急医疗
- 神经外科 神经外科
背景情况:
- 创伤激活通常依赖于机制或生理学,但抗凝剂等危险因素可以升级低能量机制.
- 一家医院修订了创伤激活标准,以包括关节骨以上受伤的抗凝血患者,旨在减少诊断创伤性内出血的延迟.
- 假设是早期创伤手术团队的参与将减少至关键干预的时间.
研究的目的:
- 评估修订后的创伤激活标准对头部受伤患者服用抗凝血药物的干预及时性的影响.
- 评估这一群体中受伤的发生率和紧急干预的需要.
主要方法:
- 单中心回顾性队列研究.
- 纳入标准:地面下跌,治疗性抗凝血或抗血小板药物,关节骨上方的损伤.
- 从2014年到2019年收集的数据,检查了2018年12月标准修订前后的伤害发生率和干预及时性.
主要成果:
- 77%的患者有轻微伤害或没有伤害;38.4%的患者从ED出院.
- 内出血发生在9.2%的患者中,四肢骨折发生在10.9%的患者中,脊椎骨折发生在5.6%的患者中.
- 检查后CT成像的时间显著降低 (76.4分比36.8分),但对内出血的干预时间没有显著变化 (281.5分比230.7分).
结论:
- 创伤外科团队参与这种低能耗抗凝血队伍可能不是一个资源高效的分配.
- 创伤外科医生进行紧急干预的可能性很低,这表明需要采用更有选择性的方法.
- 加快成像和专家参与,而不是更高的创伤激活,可能更适合这个患者群体.
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