危机中的决策:截肢时间和短期结果在严重的脚下肢创伤中
Aryan Rafieezadeh1, Kartik Prabhakaran1, Rishwanth Vetri1
1Department of Surgery, Westchester Medical Center, New York Medical College, Valhalla, New York.
The Journal of surgical research
|February 13, 2026
概括
对严重下肢损伤的早期截肢可以减少并发症和住院时间. 这种方法带来了更好的结果,包括更多的家庭排放,与延迟程序相比.
科学领域:
- 创伤外科 手术 创伤外科
- 整形外科手术 整形外科手术
- 紧急医疗 紧急医疗
背景情况:
- 截肢是管理严重下肢损伤的关键决定.
- 截肢延迟可能会增加并发症率,并对患者的结果产生负面影响.
研究的目的:
- 为了比较早期 (≤48小时) 和晚期 (>48小时) 截肢之间的结果,在患有孤立的粗严重下肢损伤的患者中进行截肢.
- 评估时间对死亡率,并发症,住院时间和出院安排的影响.
主要方法:
- 对创伤质量改善计划 (2017-2021) 的回顾性审查.
- 包括患有孤立的严重脚下肢损伤 (简称损伤量表≥3) 进行截肢的患者.
- 分为早期和晚期截肢组的分层,其次是倾向性得分匹配.
主要成果:
- 早期和晚期截肢组之间的死亡率相似 (P = 0.06).
- 早期截肢与急性损伤,骨髓炎,非计划性输管,非计划性ICU入院和返回手术室的比例明显较低有关.
- 经过早期截肢的患者在医院和重症监护室 (ICU) 停留时间更短,出院率更高.
结论:
- 在严重的脚下肢损伤中,早期截肢与较少的并发症有关.
- 较短的住院和ICU停留时间被观察到与早期截肢.
- 及时截肢可以改善出院的情况,有利于家庭出院而不是机构护理.
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