创伤性隐形肺胸部儿童的管理模式和结果
Shruthi Srinivas1, Carley Lutz1, Brenna Rachwal1
1Department of Pediatric Surgery, Nationwide Children's Hospital, Columbus, Ohio.
The Journal of surgical research
|March 15, 2026
概括
儿科创伤患者的隐性肺胸 (oPTX) 往往导致不必要的后续成像,无论结果如何. 没有常规成像的观察对稳定的患者可能是安全的.
科学领域:
- 创伤外科 手术 创伤外科
- 儿科重症监护 儿科重症监护
- 诊断成像 诊断成像 诊断成像
背景情况:
- 隐形肺胸 (oPTX) 是一种情况,肺胸在胸部X射线 (CXR) 上是看不见的,但在计算机断层扫描 (CT) 上被检测出来的.
- 在儿童创伤病例中缺乏oPTX的标准化管理协议.
- 本研究研究了oPTX在儿童中的临床表现,成像使用,干预措施和管理.
研究的目的:
- 描述当前的临床表现模式,成像利用,干预措施,以及儿科患者创伤性隐性肺胸部的管理策略.
- 评估后续成像对该人群患者结果的影响.
主要方法:
- 从2010年到2023年,一级儿科创伤中心进行了回顾性审查.
- 包括患有创伤性oPTX的儿科患者 (≤18岁),CT上定义为肺胸部,但不是CXR.
- 收集的数据包括人口统计,伤害细节,成像发现,干预和结果.
主要成果:
- 确定了162名患有oPTX的儿科患者;大多数人受到了重的创伤.
- 接受后续成像的患者的伤害严重程度得分更高,并发症更多,但没有改善结果.
- 查CXR的很大一部分 (40.5%) 被认为是不必要的,并没有改变患者的治疗.
结论:
- 儿科oPTX的后续成像通常是由损伤严重程度和并发症驱动的,不一定是通过改善结果.
- 大多数查成像没有影响临床过程,这表明有选择性使用的潜力.
- 具有较低伤害评分的无症状儿科患者可以在没有常规后续成像的情况下安全观察.
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