创伤重症监护病房收治的多发性创伤并伴有大血管损伤患者的非血管损伤管理--机构经验。

V C Ntola, T C Hardcastle, N M Nkwanyana
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引用次数: 0

摘要

背景:血管损伤的发病率和死亡率都很高。治疗要求极高,需要资深临床医生的参与。已知的血管损伤并发症包括肢体缺失、中风和死亡。目前对与血管创伤相关的其他损伤的研究还很有限。本研究旨在回顾与血管损伤相关的其他损伤的模式、处理和结果:方法:对2013年1月至2021年12月期间需要入住重症监护室的血管创伤患者进行回顾性横断面病历研究。在 2022 年 1 月至 2022 年 12 月期间,还对其他数据进行了前瞻性收集。除在确认血管损伤前死亡的患者外,所有因多发性创伤(包括血管损伤)入住创伤重症监护室的患者均接受了病历审查。损伤通过影像学或探查得到确认。对非血管损伤进行了鉴定。记录了损伤模式、处理方法和结果。使用预先设计的数据表格确定损伤类型、处理策略和结果:在 2013 年至 2022 年期间入住创伤重症监护室的 2805 名患者中,153 名(5%)患者有血管损伤。记录在案的血管损伤有 154 例,相关损伤有 212 例。本研究发现,骨折是与血管损伤相关的最常见损伤 结论:血管损伤的性质和干预延迟决定了患者的预后,但相关损伤也在影响预后方面发挥着重要作用。伴发损伤鼓励采用多学科方法来优化治疗效果。
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Management of non-vascular injuries in patients admitted in trauma ICU secondary to polytrauma with major vascular injury - Institutional experience.

Background: Vascular injuries are associated with high morbidity and mortality. The management is exceedingly demanding and requires involvement of senior clinician. There are known complications associated with vascular injury ranging from limb loss, stroke, and death. There are limited studies examining other injuries that are associated with vascular trauma. This study aimed to review the pattern, management and outcomes of the other injuries associated with vascular injuries.

Method: A retrospective cross-sectional study chart review of patients with vascular trauma requiring ICU admission between January 2013 and December 2021. Additional data was prospectively collected from January 2022 to December 2022. All patients admitted to trauma ICU with polytrauma including a vascular injury were reviewed, except patients who died prior the confirmation of vascular injury. The injury was either confirmed by imaging or via exploration. The non-vascular injuries were identified. The pattern, management and outcomes were documented. A pre-designed data proforma was used identifying injury type, management strategy, and outcomes.

Results: Out of 2805 patients that were admitted in trauma ICU from 2013 to 2022, 153 (5 %) patients had vascular injuries. There were 154 documented vascular injuries and 212 associated injuries. This study found that fractures are the most common injuries to be associated with vascular injury CONCLUSION: The nature of vascular injury and delay to intervention determines outcome of patients, however associated injuries also play an important role in affecting outcomes. The presence of associated injury encourages the multi-disciplinary approach to optimise outcomes.

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