创伤中心培训状态对形脏损伤的管理的变化
Zane J Hellmann1, Gurpreet Sohi, Carly Thaxton
1From the Department of Surgery, Yale New Haven Children's Hospital, New Haven, CT.
Journal of the American College of Surgeons
|January 21, 2026
概括
具有外科奖学金计划的儿科创伤中心在非手术治疗形脏损伤方面更成功. 这些中心的手术干预和栓塞率较低,用于儿科的形脏损伤.
科学领域:
- 儿科手术 儿科手术
- 创伤管理 创伤管理
- 外科手术的结果
背景情况:
- 非手术治疗是儿科粗脏损伤的标准,但对失败标准和管理策略缺乏共识.
- 在不同儿科创伤中心,治疗方法存在差异.
- 这项研究调查了儿科外科奖学金计划是否会影响形脏损伤的管理.
研究的目的:
- 为了确定有奖学金计划的儿科创伤中心与没有奖学金计划的中心相比,对于形脏损伤的手术干预率是否有所不同.
- 分析奖学金培训对儿科粗脊髓损伤非手术治疗成功的影响.
主要方法:
- 查询了儿科健康信息系统 (PHIS) 数据库,查询了2016-2024年间患有脏损伤的儿科患者 (≤15岁),不包括穿透创伤.
- 伤害严重性得分 (ISS) 估计使用ICD-10代码.
- 主要结局是脏手术或栓塞,通过ICD-10-PCS代码识别.
主要成果:
- 在6853名骨损伤患者中,4.7%接受了手术或内血管干预.
- 具有儿科外科奖学金计划的医院显示干预率明显较低 (4.2%对6.3%,p<0.01).
- 多变量分析证实,在奖学金附属医院的重伤患者接受脊髓切除术 (OR 0.37) 或栓塞 (OR 0.45) 的可能性较低,即使在控制混因素之后.
结论:
- 儿科手术学术奖学金培训与不手术治疗形脏损伤的更高成功率有关.
- 有奖学金计划的机构的变化较小,并且更有可能在非手术情况下成功管理形脏损伤.
- 这些发现表明,奖学金培训在优化儿科粗脊髓损伤治疗策略方面发挥着作用.
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