在创伤患者中预测计划的腹腔:末端器官功能障碍与液体复苏的作用
Linnea Cripe1, Lillian Malach1, Reid Bartholomew1
1Department of Surgery, University of Tennessee Health Science Center, Memphis, TN, USA.
American journal of surgery
|October 29, 2025
概括
早期的器官功能障碍,而不是液体复苏,预测了创伤患者的计划腹 (PVH). 识别高风险患者可以改善PVH的手术规划和临床过程预测.
科学领域:
- 创伤外科 手术 创伤外科
- 手术重症监护手术重症监护
- 腹壁的重建 腹壁的重建
背景情况:
- 重症创伤患者经常遭受复杂的腹部损伤.
- 这些损伤可能导致计划性腹 (PVH) 的发展.
- 预测PVH对于优化患者管理和手术结果至关重要.
研究的目的:
- 评估与PVH发展相关的患者因素和关键护理参数.
- 在拉巴切除术后的创伤患者中确定PVH的预测因子.
- 为临床决策提供信息,并改善患有PVH风险的创伤患者的治疗结果.
主要方法:
- 在1级创伤中心 (2020-2022) 进行拉巴切除术后患者的回顾性研究.
- 数据抽象包括人口统计,损伤特征和结果.
- 多变量逻辑回归 (MLR) 用于确定PVH的预测因素.
主要成果:
- 在899名患者中,64名 (7%) 患有PVH.
- 在24小时内,PVH与更多的无计划手术,腹内,以及更高的静脉注射液体和包装红细胞的数量有关.
- MLR确定了增加的BMI,胃肠道损伤,损伤控制腹腔切除术 (DCL),早期置换疗法 (RRT) 和早期血管压缩剂使用作为PVH的独立预测因素.
结论:
- 早期需要支持的器官功能障碍 (RRT,血管压缩剂) 与PVH有关.
- 在24小时内进行体积复苏 (IVF,PRBC) 并不是PVH的预测因素.
- 识别患有PVH风险增加的患者可以改善手术决策并预测临床疗程.
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