院前胸腔闭式引流术：有效治疗还是额外创伤？
Prehospital chest tube thoracostomy: effective treatment or additional trauma?
作者信息
Spanjersberg Willem R, Ringburg Akkie N, Bergs Engelbert A, Krijen Pita, Schipper Inger B
机构信息
Department of General Surgery and Traumatology, University of Rotterdam, Erasmus Medical Center, The Netherlands.
出版信息
J Trauma. 2005 Jul;59(1):96-101. doi: 10.1097/01.ta.0000171448.71301.13.
BACKGROUND
The use of prehospital chest tube thoracostomy (TT) remains controversial because of presumed increased complication risks. This study analyzed infectious complication rates for physician-performed prehospital and emergency department (ED) TT.
METHODS
Over a 40-month period, all consecutive trauma patients with TT performed by the flight physician at the accident scene were compared with all patients with TT performed in the emergency department. Bacterial cultures, blood samples, and thoracic radiographs were reviewed for TT-related infections.
RESULTS
Twenty-two patients received prehospital TTs and 101 patients received ED TTs. Infected hemithoraces related to TTs were found in 9% of those performed in the prehospital setting and 12% of ED-performed TTs (not significant).
CONCLUSION
The prehospital chest tube thoracostomy is a safe and lifesaving intervention, providing added value to prehospital trauma care when performed by a qualified physician. The infection rate for prehospital TT does not differ from ED TT.
背景
由于推测并发症风险增加，院前胸腔闭式引流术（TT）的应用仍存在争议。本研究分析了由医生实施的院前和急诊科（ED）TT的感染并发症发生率。
方法
在40个月的时间里，将飞行医生在事故现场为所有连续的创伤患者实施TT的情况与在急诊科实施TT的所有患者进行比较。对与TT相关感染的细菌培养、血液样本和胸部X光片进行了复查。
结果
22例患者接受了院前TT，101例患者接受了ED TT。院前实施的TT中有9%出现与TT相关的感染性半胸，ED实施的TT中有12%出现（无显著差异）。
结论
院前胸腔闭式引流术是一种安全且挽救生命的干预措施，由合格医生实施时可为院前创伤护理提供附加价值。院前TT的感染率与ED TT无差异。
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