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高电压和低电压电损伤与不良结果之间的关联:倾向匹配分析 (2002-2022)
Huayu Yang1, Ni Zhen1, Meifang Liu2
1State Key Laboratory of Trauma and Chemical Poisoning of China, Institute of Burn Research, Southwest Hospital (the First Affiliated Hospital), Third Military Medical University (Army Medical University), 29# Gao Tan Yan Street, Sha Ping Ba District, Chongqing, 400038, China.
高压电损伤导致比低压电损伤更糟糕的结果,包括更高的截肢率和早期死亡率. 尽管整体死亡率没有增加,但由于严重的后果,高压伤害需要更多的关注.
科学领域:
- 创伤外科 手术 创伤外科
- 电气伤害医学 电气伤害医学
- 烧伤护理 烧伤护理
背景情况:
- 电伤带来了复杂的治疗挑战,有限的大规模预后数据.
- 高压 (HV) 和低压 (LV) 电损伤具有不同的临床轨迹.
- 了解预后差异对于优化患者管理至关重要.
研究的目的:
- 对高电压与低电压电损伤的临床预后进行深入分析.
- 为了比较包括死亡率,截肢率,烧伤严重程度和不良事件在内的结果.
- 识别与高压暴露相关的特定风险.
主要方法:
- 在二十年内对1426名电伤患者进行了回顾性研究.
- 分类为高压 (n=772) 和低压 (n=654) 组.
- 倾向性得分匹配 (PSM),然后进行后勤,线性和生存分析.
主要成果:
- 高压伤害显著增加了截肢率 (OR: 3.02),14天死亡率 (HR: 5.40),住院时间 (β: 34.75天) 和烧伤面积 (β: 8.00厘米2).
- 大脑血管损伤与更多的手术,意识障碍和气管切割要求有关.
- 在HV和LV组之间没有发现任何原因死亡率的显著差异.
结论:
- 高压电损伤与较低压电损伤相比,早期预后明显差,严重程度增加.
- 虽然没有增加整体住院死亡率,但HV损伤需要提高临床警和资源配置.
- 强调高压电损伤的独特危害对于改善患者的治疗结果至关重要.
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