Alzamel Heythem A, Cohn Stephen M
Division of Trauma, University of Miami School of Medicine, Miami, Florida, USA.
J Trauma. 2005 Mar;58(3):523-5. doi: 10.1097/01.ta.0000152987.21630.39.
This study sought to determine the time from hospital presentation to surgical intervention for hemodynamically stable patients with abdominal stab wounds. The objective was to identify the optimal time for observation of these asymptomatic patients before safe hospital discharge.
The authors reviewed a prospectively collected trauma database at their level 1 trauma center. The time from admission to surgery was noted in their patient population. All stab wound patients who underwent either peritoneal lavage or immediate surgery were excluded from the study.
During a 7-year period, 650 asymptomatic patients with abdominal stab wounds were admitted for serial examination. The study showed that 567 of these patients had no abdominal surgical intervention, whereas 68 underwent abdominal surgery (15 left the center against medical advice). No patients were identified as requiring surgery more than 12 hours after presentation.
It appears that asymptomatic patients with abdominal stab wounds may be discharged from the hospital after 12 hours of observation with little likelihood of missed injury.
本研究旨在确定血流动力学稳定的腹部刺伤患者从入院到手术干预的时间。目的是确定这些无症状患者在安全出院前的最佳观察时间。
作者回顾了他们一级创伤中心前瞻性收集的创伤数据库。记录了患者群体从入院到手术的时间。所有接受腹腔灌洗或立即手术的刺伤患者均被排除在研究之外。
在7年期间，650例无症状腹部刺伤患者入院接受系列检查。研究表明，这些患者中有567例未接受腹部手术干预，而68例接受了腹部手术（15例违背医嘱离开中心）。没有患者在就诊后超过12小时被确定需要手术。
似乎腹部刺伤无症状患者在观察12小时后可出院，漏诊损伤的可能性很小。
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