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胸部创伤后的de novo肺栓塞:事实还是虚构?
Onchuda Wongweerakit1,2, Burapat Sangthong3, Osaree Akaraborworn3
1Division of Trauma and Critical Care, Department of Surgery, Faculty of Medicine, Prince of Songkla University, Hat Yai, Songkhla, Thailand. Onchuda.sxpsu@gmail.com.
概括
新发性肺栓塞 (DNPE) 在创伤患者中更常见,但胸部创伤不是一个显著的危险因素. 需要进一步的研究来了解DNPE在创伤幸存者的起源.
科学领域:
- 创伤护理 创伤护理
- 肺部医学 肺部医学
- 血管外科 血管外科
背景情况:
- 肺栓塞 (PE) 在创伤后可以在肺部 (DNPE) 中出现 de novo.
- 严重的胸部创伤是由于炎症,血管损伤和静脉静止而导致的DNPE的疑似危险因素.
- 了解DNPE的起源对于创伤患者管理至关重要.
研究的目的:
- 研究创伤患者中新发肺栓塞 (DNPE) 和胸部创伤之间的关联.
- 描述诊断为DNPE的患者的临床概况.
- 为了区分DNPE与源于深静脉血栓塞 (DVT) 的PE.
主要方法:
- 在1级创伤中心 (2013-2023) 的创伤患者 (≥15年) 的回顾性队列研究.
- 审查了诊断为创伤后PE的患者的临床数据,成像和治疗方法.
- 没有深静脉血栓形成 (DVT) 的患者被排除在外. 超声波评估.
主要成果:
- 在43,908名创伤患者中,78名 (0.18%) 患有PE;74人被分析.
- 49名患者 (66%) 患有DNPE,25名患者 (34%) 患有PE与DVT.
- 与PE+DVT患者 (32%) 相比,DNPE患者 (38.8%) 的胸部创伤发病率没有显著增加.
- 与PE+DVT相比,DNPE显著增加了外围栓塞 (79.6%),而PE+DVT则显著增加了中心栓塞 (52%).
结论:
- 在创伤患者中经常观察到新的肺栓塞 (DNPE).
- 没有发现胸部创伤是DNPE的统计学上显著的风险因素.
- DNPE的发展可能涉及未检测到的盆腔DVT或其他需要进一步调查的不具特征的机制.
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