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Where the land ends and the sea begins. 陆地的尽头和海洋的起点
Pub Date : 2023-06-09 DOI: 10.20408/jti.2022.0081
Kun Hwang
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引用次数: 0
Quality monitoring of resuscitative endovascular balloon occlusion of the aorta using cumulative sum analysis in Korea: a case series. 应用累积和分析对复苏血管内球囊阻塞主动脉的质量监测
Pub Date : 2023-06-01 Epub Date: 2022-12-21 DOI: 10.20408/jti.2022.0069
Hyunsik Choi, Joongsuck Kim, Kwanghee Yeo, Ohsang Kwon, Kyounghwan Kim, Wu Seong Kang

Purpose: Resuscitative endovascular balloon occlusion of the aorta (REBOA) is a state-of-the-art lifesaving procedure. However, due to its high mortality and morbidity, including ischemia and reperfusion injury, well-trained medical staff and effective systems are needed. This study was conducted to investigate the learning curve for REBOA in Korea.

Methods: To monitor this learning curve, we used cumulative sum (CUSUM) analysis and graphs of mortality and aortic occlusion time within 60, 90, and 120 minutes for consecutive patients. The procedures performed between July 2017 and June 2021 were divided into pre-trauma center (pre-TC; July 2017-February 2020) and TC (February 2020-June 2021) periods.

Results: REBOA was performed for 31 consecutive patients with trauma. The pre-TC (n=12) and TC (n=19) periods did not differ significantly with regard to Injury Severity Score, age, injury mechanism, initial systolic blood pressure, prehospital cardiopulmonary resuscitation (CPR), or CPR in the emergency department. At the 17th consecutive patient during the TC period, CUSUM failure graphs for mortality and aortic occlusion time exhibited a downward inflection, indicating an improvement in performance.

Conclusions: The mortality and aortic occlusion time of REBOA improved, and these parameters can be monitored using CUSUM analysis at the hospital level.

目的:复苏血管内球囊阻塞主动脉(REBOA)是一种先进的挽救生命的程序。然而,由于其高死亡率和发病率,包括缺血再灌注损伤,需要训练有素的医务人员和有效的系统。本研究旨在探讨REBOA的学习曲线。方法:为了监测这一学习曲线,我们使用累积和(CUSUM)分析以及连续患者在60min、90min和120min内的死亡率和主动脉阻塞时间曲线图。2017年7月至2021年6月间进行的手术分为创伤前中心(pre-TC;2017年7月至2020年2月)和TC(2020年2月至2021年6月)期间。结果:连续31例外伤患者行REBOA手术。TC前(n=12)和TC期(n=19)在损伤严重程度评分、年龄、损伤机制、初始收缩压、院前心肺复苏(CPR)或急诊科CPR方面无显著差异。在TC期间连续第17例患者,死亡率和主动脉阻塞时间的CUSUM失效图呈下降趋势,表明性能有所改善。结论:REBOA的死亡率和主动脉阻塞时间均有改善,可在医院层面采用CUSUM分析进行监测。
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引用次数: 0
Experience of surgical treatments for abdominal inferior vena cava injuries in a regional trauma center in Korea. 韩国区域创伤中心腹下腔静脉损伤的外科治疗体会
Pub Date : 2023-06-01 Epub Date: 2023-06-15 DOI: 10.20408/jti.2023.0001
Jin Woo Park, Dong Hun Kim

Purpose: Inferior vena cava (IVC) injuries are a rare type of traumatic abdominal injuries that are challenging to treat and have a very high mortality rate. This study described our experience with the surgical treatment of traumatic IVC injuries, and we investigated the demographics, clinical profiles, and surgical outcomes of cases at a regional trauma center.

Methods: Among the 16 patients who were treated for a traumatic IVC injury between January 2014 and March 2022, 14 underwent surgery. The surgical outcomes included overall mortality and 24-hour mortality, and we investigated the factors associated with these surgical outcomes. The 14 patients were divided into two groups according to the location of the IVC injury (retrohepatic IVC or higher vs. subhepatic IVC), and differences between the two groups were analyzed.

Results: A body mass index (BMI) >23.0 kg/m2 (P=0.046), an elevated serum lactate level (P=0.043), and a shorter operation time (P=0.016) were associated with overall mortality. A higher BMI (P=0.050), higher serum lactate level (P=0.004), shorter operation time (P=0.005), and an injury at the retrohepatic IVC or higher level (P=0.031) were associated with 24-hour mortality. Younger age (P=0.028), higher BMI (P=0.005), more acidic pH, higher lactatemia (P=0.012), a higher hemoglobin level (P=0.012), and shorter door-to-operating room time (P=0.028) were associated with injury at the retrohepatic IVC or higher level. Patients with subhepatic IVC injuries had a high rate of direct repair (75.0%) and a significantly lower 24-hour mortality rate (37.5%, P=0.031).

Conclusions: Subhepatic IVC injuries are easy to access and are usually expected to treat with a direct repair method. Injuries at the retrohepatic IVC or higher level are difficult to treat surgically and require a systematic and multidisciplinary treatment strategy.

目的:下腔静脉(IVC)损伤是一种罕见的创伤性腹部损伤,治疗难度大,死亡率高。这项研究描述了我们对创伤性IVC损伤的手术治疗经验,并调查了地区创伤中心病例的人口统计学、临床特征和手术结果。方法:在2014年1月至2022年3月期间接受创伤IVC损伤治疗的16名患者中,14人接受了手术。手术结果包括总死亡率和24小时死亡率,我们调查了与这些手术结果相关的因素。根据IVC损伤的位置将14名患者分为两组(肝后IVC或更高的IVC与肝下IVC),并分析两组之间的差异。结果:体重指数(BMI)>23.0 kg/m2(P=0.046)、血清乳酸水平升高(P=0.043)和手术时间缩短(P=0.016)与总死亡率相关。较高的BMI(P=0.050)、较高的血清乳酸水平(P=0.004)、较短的手术时间(P=0.005)以及肝后IVC或更高水平的损伤(P=0.031)与24小时死亡率相关。年龄较小(P=0.028)、BMI较高(P=0.005)、酸性pH值较高(P=0.028。肝下下腔静脉损伤的直接修复率高(75.0%),24小时死亡率显著降低(37.5%,P=0.031)。肝后IVC或更高级别的损伤很难通过手术治疗,需要系统和多学科的治疗策略。
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引用次数: 0
Endovascular treatment of traumatic iliac venous injury combined with phlegmasia cerulea dolens in Korea: a case report. 血管内治疗外伤性髂静脉损伤合并青蓝痰1例
Pub Date : 2023-06-01 Epub Date: 2022-12-01 DOI: 10.20408/jti.2022.0039
Suyoung Park, Jeong Ho Kim, Jung Han Hwang, Jayun Cho

Traumatic iliac venous injury is rare but can be fatal. Although surgical management is considered a primary treatment method, urgent treatment is required when deep venous thrombosis and subsequent phlegmasia cerulea dolens is combined. It is difficult to treat by surgical management, and pharmaceutic thrombolysis cannot be applied due to the trauma history. Here, we describe a case of unilateral traumatic iliac venous injury and subsequent diffuse venous thrombosis in the affected iliofemoral and infrapopliteal veins, combined with phlegmasia cerulea dolens, treated with endovascular management, including bare metal stent insertion and aspiration thrombectomy.

外伤性髂静脉损伤是罕见的,但可以致命。虽然手术治疗被认为是主要的治疗方法,但当深静脉血栓形成和随后的蓝核痰症合并时,需要紧急治疗。很难通过手术治疗
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引用次数: 0
Management of a traumatic avulsion fracture of the occipital condyle in polytrauma patient in Korea: a case report. 外伤性枕髁撕脱骨折一例治疗
Pub Date : 2023-06-01 Epub Date: 2022-12-08 DOI: 10.20408/jti.2022.0058
Chang Hwa Ham, Woo-Keun Kwon, Joo Han Kim, Youn-Kwan Park, Jong Hyun Kim

Avulsion fracture of the occipital condyle are rare lesion at craniovertebral junction. It is often related to high-energy traumatic injuries and show diverse clinical presentations. Neurologic deficit and instabilities may justify surgical treatment. However, the integrity of neurovascular structures is undervalued in the current literatures. In this case report, we described a 26-year-old female patient with avulsion fracture of occipital condyle following a traffic accident. On initial presentation, her Glasgow Coma Scale was 8. She presented with fracture compound comminuted depressed, on the left side of her forehead with skull base fracture extending into clivus and occipital condyle. Her left occipital condyle showed avulsion injury with displacement deep into the skull base. On her computed tomography angiography, the displaced occipital condyle compressed on the sigmoid sinus resulting in its obstruction. While she was recovering her consciousness during her stay in the hospital, the lower cranial nerves showed dysfunctions corresponding to Collet-Sicard syndrome. Due to high risk of vascular injury, the patient was conservatively treated for the occipital condyle fracture. On the 4 months postdischarge follow-up, her cranial nerve symptoms practically recovered, and the occipital condyle showed signs of fusion without further displacement. Current literatures focus on neurologic deficit and stability for the surgical decisions. However, it is also important to evaluate the neurovascular integrity to assess the risk of its manipulation as it may result in fatal outcome. This case shows, an unstable avulsion occipital condyle fracture with neurologic deficit can be treated conservatively and show a favorable outcome.

枕髁撕脱性骨折是颅椎交界处罕见的损伤。它通常与高能创伤有关,并表现出不同的临床表现。神经系统缺陷和不稳定可能证明手术治疗是合理的。然而,神经血管结构的完整性在目前的文献中并不被低估。在本病例报告中,我们描述了一名26岁的女性患者,在一次交通事故后发生枕髁撕脱性骨折。在最初的陈述中,她的格拉斯哥昏迷量表为8。她表现为骨折复合粉碎性凹陷,前额左侧颅底骨折延伸至斜坡和枕髁。她的左枕髁出现撕脱伤,移位至颅底深处。在她的计算机断层扫描血管造影术中,移位的枕髁压迫乙状窦,导致其阻塞。在住院期间,当她正在恢复意识时,下颅神经出现了与Collet-Sicard综合征相对应的功能障碍。由于血管损伤的风险很高,患者接受了枕髁骨折的保守治疗。在出院后4个月的随访中,她的脑神经症状实际上已经恢复,枕髁显示融合迹象,没有进一步移位。目前的文献主要集中在神经功能缺损和手术决策的稳定性方面。然而,评估神经血管完整性以评估其操作的风险也很重要,因为这可能会导致致命的结果。该病例显示,不稳定的枕髁撕脱性骨折伴神经功能缺损可以保守治疗,并显示出良好的结果。
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引用次数: 0
Spontaneous recanalization of complete urethral injury treated by suprapubic cystostomy alone after severe pelvic bone fracture in a young male patient in Korea: a case report. 青年男性严重骨盆骨折后耻骨上膀胱造瘘术治疗完全性尿道损伤的自发再通1例
Pub Date : 2023-06-01 Epub Date: 2022-12-02 DOI: 10.20408/jti.2022.0056
Han Kyul Shin, Gi Ho Moon, Sung Yub Jeong, Ho Jun Lee

Injury to the genitourinary tract is rare, with an incidence of less than 1%. Younger men (mean age, approximately 30 years) are predominantly affected. We introduce an unusual case of a 25-year-old male patient with complete urethral injury combined with a severe open pelvic bone fracture. During the emergency surgery, the primary realignment of the posterior urethra could not be performed due to a large defect. With suprapubic cystostomy alone, follow-up voiding cystourethrography showed spontaneous recanalization of the transected urethra after four months. Suprapubic cystostomy is an efficient treatment option when primary realignment is not possible.

泌尿生殖道损伤是罕见的,发生率低于1%。年轻男性(平均年龄约30岁)主要受到影响。我们介绍一个不寻常的案例,一个25岁男性患者完全尿道损伤合并严重开放性骨盆骨折。在紧急手术中,由于一个大的缺陷,后尿道的初次重新排列无法进行。单独进行耻骨上膀胱造瘘术后,随访排尿膀胱尿道造影显示,四个月后横切尿道自发再通。肩胛上膀胱造瘘术是一种有效的治疗选择时,主要调整是不可能的。
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引用次数: 0
Effect of use and type of helmet on occurrence of traumatic brain injuries in motorcycle riders in Korea: a retrospective cohort study. 头盔的使用和类型对摩托车驾驶员颅脑损伤发生率的影响
Pub Date : 2023-06-01 Epub Date: 2022-12-09 DOI: 10.20408/jti.2022.0029
Sowon Seo, Seok Ran Yeom, Sung-Wook Park, Il Jae Wang, Suck Ju Cho, Wook Tae Yang, Youngmo Cho

Purpose: The purpose of this study was to investigate (1) the association among helmet wearing, incidence rate of traumatic brain injury (TBI), and in-hospital mortality; TBI was diagnosed when the head Abbreviated Injury Scale (AIS) was ≥1, and as severe TBI when head AIS was ≥3; and (2) the association between helmet type and incidence rate of TBI, severe TBI, and in-hospital mortality of motorcycle accidents based on the newly revised Emergency Department-based Injury In-depth Surveillance (EDIIS) data.

Methods: Data collected from EDIIS between January 1, 2020 and December 31, 2020 were analyzed. The final study population comprised 1,910 patients, who were divided into two groups: helmet wearing group and unhelmeted group. In addition, the correlation between helmet type and motorcycle accident was determined in 596 patients who knew the exact type of helmet they wore. A total of 710 patients who wore helmet but did not know the type were excluded from this analysis. Multivariate logistic regression was performed in both the groups to investigate the factors affecting the primary (occurrence of TBIs) and secondary outcomes (severe TBI and in-hospital mortality).

Results: The prevalence of Injury Severity Scores, TBIs, and severe TBIs as well as in-hospital mortality were the highest in the unhelmeted group. Additionally, the results from the group that wore and knew the type of helmet worn indicated that wearing a full-face helmet decreased the incidence of TBIs in comparison to a half-face helmet.

Conclusions: The wearing of a helmet in motorcycle accidents is very important as it plays a role in reducing the occurrence of TBIs and severe TBIs and in-hospital mortality. The use of a full-face helmet lowered the incidence of TBIs.

目的:本研究的目的是调查(1)头盔佩戴、创伤性脑损伤(TBI)发生率和住院死亡率之间的关系;当头部简易损伤量表(AIS)≥1时诊断为TBI,当头部AIS≥3时诊断为严重TBI;以及(2)基于最新修订的基于急诊科的损伤深度监测(EDIIS)数据,头盔类型与摩托车事故的TBI、严重TBI和住院死亡率的发病率之间的关联。方法:分析2020年1月1日至2020年12月31日期间从EDIIS收集的数据。最终研究人群包括1910名患者,他们被分为两组:戴头盔组和不戴口罩组。此外,在596名知道自己所戴头盔确切类型的患者中,确定了头盔类型与摩托车事故之间的相关性。共有710名戴头盔但不知道头盔类型的患者被排除在该分析之外。对两组患者进行多变量逻辑回归,以调查影响原发性(TBI的发生)和继发性结果(严重TBI和住院死亡率)的因素。结果:未保温组的损伤严重程度评分、TBI、严重TBI的患病率以及住院死亡率最高。此外,佩戴并知道所戴头盔类型的组的结果表明,与半面罩相比,佩戴全面罩可以降低TBI的发生率。结论:在摩托车事故中佩戴头盔非常重要,因为它在减少TBI和严重TBI的发生以及住院死亡率方面发挥着作用。全脸头盔的使用降低了创伤性脑损伤的发生率。
{"title":"Effect of use and type of helmet on occurrence of traumatic brain injuries in motorcycle riders in Korea: a retrospective cohort study.","authors":"Sowon Seo, Seok Ran Yeom, Sung-Wook Park, Il Jae Wang, Suck Ju Cho, Wook Tae Yang, Youngmo Cho","doi":"10.20408/jti.2022.0029","DOIUrl":"10.20408/jti.2022.0029","url":null,"abstract":"<p><strong>Purpose: </strong>The purpose of this study was to investigate (1) the association among helmet wearing, incidence rate of traumatic brain injury (TBI), and in-hospital mortality; TBI was diagnosed when the head Abbreviated Injury Scale (AIS) was ≥1, and as severe TBI when head AIS was ≥3; and (2) the association between helmet type and incidence rate of TBI, severe TBI, and in-hospital mortality of motorcycle accidents based on the newly revised Emergency Department-based Injury In-depth Surveillance (EDIIS) data.</p><p><strong>Methods: </strong>Data collected from EDIIS between January 1, 2020 and December 31, 2020 were analyzed. The final study population comprised 1,910 patients, who were divided into two groups: helmet wearing group and unhelmeted group. In addition, the correlation between helmet type and motorcycle accident was determined in 596 patients who knew the exact type of helmet they wore. A total of 710 patients who wore helmet but did not know the type were excluded from this analysis. Multivariate logistic regression was performed in both the groups to investigate the factors affecting the primary (occurrence of TBIs) and secondary outcomes (severe TBI and in-hospital mortality).</p><p><strong>Results: </strong>The prevalence of Injury Severity Scores, TBIs, and severe TBIs as well as in-hospital mortality were the highest in the unhelmeted group. Additionally, the results from the group that wore and knew the type of helmet worn indicated that wearing a full-face helmet decreased the incidence of TBIs in comparison to a half-face helmet.</p><p><strong>Conclusions: </strong>The wearing of a helmet in motorcycle accidents is very important as it plays a role in reducing the occurrence of TBIs and severe TBIs and in-hospital mortality. The use of a full-face helmet lowered the incidence of TBIs.</p>","PeriodicalId":52698,"journal":{"name":"Journal of Trauma and Injury","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11309454/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46025144","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Delayed open abdomen closure using a combination of acellular dermal matrix and skin graft in Korea: a case report. 脱细胞真皮基质与植皮联合应用延迟开放性腹部闭合术1例
Pub Date : 2023-06-01 Epub Date: 2022-11-04 DOI: 10.20408/jti.2022.0024
Yoonseob Kim, Tae Ah Kim, Hyung Min Hahn, Byung Hee Kang

Delayed closure of an open abdomen (OA) is a clinically challenging task despite its various modalities. It is substantially more difficult when the duration of OA treatment is prolonged due to a patient's condition. We introduced the management of a patient who had a delayed OA treatment spanning approximately 3 months due to severe abdominal contamination. The 64-year-old male patient had an injured pelvis pressed by a road roller. After visiting a trauma center, the patient initially underwent damage control surgery and OA management; however, early primary abdominal closure failed due to severe peritonitis. After negative pressure wound therapy for several months, an acellular dermal matrix graft followed by a skin graft were successfully used as treatments. A combination of acellular dermal matrix graft, negative pressure wound therapy, and skin graft techniques is a considerable management sequence for patients subjected to delayed OA treatment.

延迟闭合开放性腹部(OA)是一项具有临床挑战性的任务,尽管其模式多种多样。当OA治疗的持续时间由于患者的病情而延长时,这将变得更加困难。我们介绍了一名患者的治疗方法,该患者因严重腹部污染而延迟了约3个月的OA治疗。这名64岁的男性患者被压路机压伤了骨盆。在访问创伤中心后,患者立即接受了损伤控制手术和OA管理;然而,由于严重的腹膜炎,早期原发性腹部闭合失败。经过几个月的负压伤口治疗,脱细胞真皮基质移植物和皮肤移植物被成功地用作治疗。脱细胞真皮基质移植物、负压伤口治疗和皮肤移植技术的结合是延迟OA治疗患者的一个相当大的管理序列。
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引用次数: 0
External iliac artery injury with posterior pelvic ring injury in Korea: two case reports. 髂外动脉损伤合并骨盆后环损伤2例报告
Pub Date : 2023-06-01 Epub Date: 2022-12-01 DOI: 10.20408/jti.2022.0046
Joosuk Ahn, Ji Wan Kim

Pelvic ring injuries associated with external iliac artery injuries are rare and may be life-threatening condition. The most important factors in the managements are the immediate bleeding control and restoration of distal blood flow. We report two cases of pelvic ring injuries with external artery injuries. One case was occlusion of external iliac artery with concomitant rupture of internal iliac artery. The other case was ruptured external iliac artery. Every surgeon must understand the possibility of hidden lesions-for example, arterial rupture and thrombus-and should consider the need for embolization or thrombectomy when treating this type of injury.

伴有髂外动脉损伤的骨盆环损伤非常罕见,可能会危及生命。处理的最重要因素是立即控制出血和恢复远端血流。我们报告了两例骨盆环损伤合并髂外动脉损伤的病例。一例是髂外动脉闭塞,同时髂内动脉破裂。另一例是髂外动脉破裂。每位外科医生都必须了解隐藏病变的可能性--例如动脉破裂和血栓,并且在治疗这类损伤时应考虑是否需要进行栓塞或血栓切除术。
{"title":"External iliac artery injury with posterior pelvic ring injury in Korea: two case reports.","authors":"Joosuk Ahn, Ji Wan Kim","doi":"10.20408/jti.2022.0046","DOIUrl":"10.20408/jti.2022.0046","url":null,"abstract":"<p><p>Pelvic ring injuries associated with external iliac artery injuries are rare and may be life-threatening condition. The most important factors in the managements are the immediate bleeding control and restoration of distal blood flow. We report two cases of pelvic ring injuries with external artery injuries. One case was occlusion of external iliac artery with concomitant rupture of internal iliac artery. The other case was ruptured external iliac artery. Every surgeon must understand the possibility of hidden lesions-for example, arterial rupture and thrombus-and should consider the need for embolization or thrombectomy when treating this type of injury.</p>","PeriodicalId":52698,"journal":{"name":"Journal of Trauma and Injury","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11309450/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43931658","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Submental intubation using laparoscopic trocar in zygomaticomaxillary complex fracture surgery in Korea: a case report. 腹腔镜套管针在颧颌复合体骨折手术中应用颏下插管1例
Pub Date : 2023-06-01 Epub Date: 2022-12-21 DOI: 10.20408/jti.2022.0036
Hyejin Do, Chunui Lee, Hyeon Don Hong, Hyejin Hong, Hyun Kyo Lim, Sujin Kim

Submental intubation is an effective alternative technique for airway management in patients with maxillofacial trauma. Compared with tracheostomy, it is less invasive, but has risks associated with potential airway compromise such as hypoxia due to tube obstruction, collapse, and kinking. To shorten procedure time and ensure a reinforced tube lumen, we used a laparoscopic trocar as a new device for submental intubation. A 54-year-old male patient sustained a zygomaticomaxillary complex fracture and was scheduled to undergo open reduction and internal fixation. We performed intraoral intubation and made a small 1-cm incision at the submandibular midline. After dissection of the tissue from the incision site, a reinforced tube was passed using a 12-mm laparoscopic trocar. The procedure took about 5 minutes, and apnea time from disconnecting the breathing circuit and passing through the internal lumen of the trocar until it was reconnected to the ventilator was 1 minute 5 seconds. Using a laparoscopic trocar for submental intubation can reduce the time required for dissection, prevent luminal occlusion complications due to soft tissues or blood clots in the endotracheal tube, and decrease soft tissue damage.

颏下插管是颌面部创伤患者气道管理的有效替代技术。与气管造口术相比,它的侵入性较小,但有潜在气道损害的风险,如气管阻塞、塌陷和扭结引起的缺氧。为了缩短手术时间和确保加强管腔,我们使用腹腔镜套管针作为一种新的装置进行颏下插管。一名54岁男性患者持续颧骨腋窝复合体骨折,计划接受切开复位和内固定。我们进行了口内插管,并在下颌中线处做了一个1厘米的小切口。从切口部位剥离组织后,使用12毫米腹腔镜套管针通过强化管。整个过程耗时约5分钟,从断开呼吸回路并通过套管针内腔到重新连接呼吸机的呼吸暂停时间为1分5秒。使用腹腔镜套管针进行颏下插管,可以缩短解剖时间,防止气管内软组织或血块导致腔隙闭塞并发症,减少软组织损伤
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引用次数: 0
期刊
Journal of Trauma and Injury
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