非手术治疗形创伤性大动脉损伤的非手术治疗
Veysel Embel1, Muhammad Saad Hafeez2, Larissa Russo3
1Department of Surgery, Jersey Shore University Medical Center, Neptune, NJ 07753, United States.
World journal of cardiology
|January 29, 2026
概括
非手术治疗 (NOM) 对低度的形创伤性大动脉损伤 (BTAI) 有效,显示较低的死亡率和更少的干预. 有限的数据表明,NOM可能适用于精选的高等级BTAI患者,需要进一步研究.
科学领域:
- 创伤外科 手术 创伤外科
- 血管外科 血管外科
- 心血管研究研究心血管研究
背景情况:
- 形创伤性大动脉损伤 (BTAI) 是高速碰撞的严重后果.
- 管理已经从开放性修复演变为内血管大动脉修复 (TEVAR) 和非手术性管理 (NOM).
- 目前的指导方针建议NOM用于I级BTAI,并越来越多地支持II级受伤.
研究的目的:
- 审查关于粗创伤性大动脉损伤 (BTAI) 的非手术管理 (NOM) 的文献.
- 评估NOM的结果与内血管修复 (TEVAR) 和BTAI的开放修复相比.
- 评估高度BTAI中NOM的潜力,特别是III级受伤.
主要方法:
- 通过PubMed,CINHAL,EBSCO和谷歌学者进行了一项回顾性文献审查.
- 包括2003年1月至2023年12月期间发表的研究,重点是队列,病例控制和观察性研究.
- 对比了NOM,TEVAR和BTAI的开放修复之间的结果.
主要成果:
- 对于I级和II级BTAI,NOM与降低死亡率,减少非计划性干预和成功的病理解决有关.
- 有限的研究表明,NOM可能会为精选的III级BTAI患者带来合理的结果,具有很高的分辨率.
- 在所有治疗方式中,观察到较高BTAI等级的死亡率上升的趋势.
结论:
- 目前的文献支持低等级BTAI (等级I和II) 的NOM.
- 虽然指导方针建议TEVAR用于III级BTAI,但一些证据表明NOM与积极监测对特定患者是可行的.
- 需要进一步的研究来直接比较NOM与TEVAR对于更高等级的BTAI种群.
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