脾脏创伤的适当处理

Mariana Nunes Gazolla, Emanuele Souza Dias, Layanne Bosse, Fabricio Augusto Pedrão de Almeida Prado, Lucas Gabriel Carlesse Paloco, Enzo Ricardo Pedrão de Almeida Prado, Tércio Ernandes Cruz de Melo, Barbara de Abreu Canton, Célia Maria Macedo de Camargo, Ana Amélia Athaydes Clusella de Mello, Aline Araújo Nogueira, Arthur Azevedo Barbosa, Laíse Araújo Nogueira, Letícia de Araújo Ribas, Vinícius Coutinho Guedes, Daniela Jaime e Silva, Jéssica Milanêz Melo de Araújo, Dra. Aline de Amorim Duarte
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引用次数: 0

摘要

简介:脾外伤的处理不当与高发病率和死亡率有关,有效了解其机制至关重要。闭合性腹部或胸腹外伤,如各种事故引起的局部挫伤,是脾脏损伤的典型原因。脾损伤必须在紧急情况下及时评估,并根据损伤程度进行手术治疗。方法:对手术患者的医疗记录进行回顾性、定量和横断面分析。结果:对50例患者的病历进行分析、评分,并根据以下变量进行选择:创伤机制、脾损伤临床体征、脾切除术作为急诊入路、损伤程度、术后时间、并发症、后遗症、术后住院时间、是否需要重症监护病房入住和死亡率。研究人员从50例紧急脾切除术患者的医疗记录中得出结论,48%的患者因车祸经历了脾脏损伤,38%的患者有凯尔征。此外,在解剖病理检查后,确定在70%的紧急脾切除术病例中,III-V级损伤最为常见。此外,局部脓肿,最常见的并发症类型,出现在50%的患者。平均住院时间为8天,38%的患者需要重症监护病房。最后,有可能得出10%死亡的结论。在护理方面,已经建立了一个概况,其中需要直接和有效的方法,因为与目前的文献相比,与保守方法相比,并发症的患者数量非常少,保守方法的患者根据损伤程度的不同,后遗症程度为70%。结论:因此,加强了对旨在降低发病率和死亡率的更有效政策的需求。考虑到实例的高频率,这一点至关重要。
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Appropriate Management of Splenic Trauma
Introduction: Inappropriate management of splenictrauma is related to high rates of morbidity and mortality, and an effective understanding of its mechanisms is vital. Closed abdominal or thoracoabdominal trauma, such as localized contusions from various incidents, is typically the cause of splenic injuries. Splenic trauma must be promptly evaluated in the context of urgency, and a surgical approach must be performed according to the degree of injury. Methods: This is a retrospective, quantitative, and cross-sectional analysis of the medical records of operated-on patients. Results: The medical records of 50 patients were analyzed, scored, and selected based on the following variables: mechanism of trauma, clinical signs of splenic injury, splenectomy as an emergency approach, degree of injury, postoperative period, complications, sequelae, and length of stay after surgery, as well as the need for intensive care unitadmission and mortality. Data from 50 medical records of patients undergoing urgent splenectomy allowed researchers to draw the conclusion that 48% of patients had experienced splenic trauma as a result of auto accidents, and 38% of patients had Kehr's sign. Additionally, it was determined that grade III–V injuries were the most common in 70% of the cases submitted for urgent splenectomy after an anatomopathological investigation. Further, localized abscesses, the most common type of complications, were present in 50% of the patients. The average length of stay was 8 days, and 38% of the patients needed an intensive care unit. Finally, it was possible to conclude that 10% died. In terms of care, a profile has been established in which a direct and effective approach is required because, when compared with current literature, the number of patients with complications is very low when compared to patients approached conservatively, who present a degree of sequelae of 70% depending on the degree of injury. Conclusion: As a result, the demand for more effective policies that aim to reduce morbidity and mortality is reinforced. This is critical given the high frequency of instances.
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