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骨盆骨折创伤患者的腹部实性脏器损伤

Abdominal solid organ injury in trauma patients with pelvic bone fractures.

作者信息

Kwon Hyo-Min, Kim Sun-Hyu, Hong Jung-Seok, Choi Wook-Jin, Ahn Ryeok, Hong Eun-Seog

机构信息

Department of Emergency Medicine, University of Ulsan College of Medicine, Ulsan University Hospital, Ulsan, South Korea.

出版信息

Ulus Travma Acil Cerrahi Derg. 2014 Mar;20(2):113-9. doi: 10.5505/tjtes.2014.72698.

Abstract

BACKGROUND

We analyzed the clinical progression of trauma patients with pelvic bone fractures so to determine the risk factors associated with sustaining concurrent abdominal solid organ injuries.

METHODS

This study was a retrospective chart review. Subjects were categorized based on injury type: solid organ versus non-solid organ injury groups. These study groups were compared based on demographics, treatments, and clinical outcomes. Potential risk factors that may contribute to the occurrence of abdominal solid organ injury in trauma patients with pelvic bone fractures were evaluated.

RESULTS

The solid organ injury group included 17.4% of all the patients in the study (n=69). Fall from height occurred at greater distances in patients that sustained solid organ injuries as opposed to patients with non-solid organ injuries. Initial blood pressure and Revised Trauma Scores were lower in the solid organ injury group. Shock diagnosed immediately upon emergency department arrival was a risk factor for intra-abdominal solid organ injuries in trauma patients with pelvic bone fractures. Clinical prognosis for patients in the solid organ injury group was poorer and more invasive treatments were performed for patients in this group.

CONCLUSION

Traumatic pelvic fracture patient prognosis needs to be improved through early diagnosis and prompt delivery of aggressive treatments based on rapid identification of abdominal solid organ injuries.

摘要

背景

我们分析了骨盆骨折创伤患者的临床进展情况,以确定并发腹部实体器官损伤的相关危险因素。

方法

本研究为回顾性病历审查。根据损伤类型对受试者进行分类:实体器官损伤组与非实体器官损伤组。基于人口统计学、治疗方法和临床结果对这些研究组进行比较。评估了可能导致骨盆骨折创伤患者发生腹部实体器官损伤的潜在危险因素。

结果

实体器官损伤组占研究中所有患者的17.4%(n = 69)。与非实体器官损伤患者相比,发生实体器官损伤的患者从更高处跌落。实体器官损伤组的初始血压和修订创伤评分较低。急诊科到达时立即诊断出的休克是骨盆骨折创伤患者腹部实体器官损伤的危险因素。实体器官损伤组患者的临床预后较差,且该组患者接受了更具侵入性的治疗。

结论

需要通过早期诊断并基于快速识别腹部实体器官损伤及时进行积极治疗,来改善创伤性骨盆骨折患者的预后。

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