1999年至2009年伊利诺伊州小儿创伤的复苏性开胸手术
Resuscitative thoracotomy for pediatric trauma in Illinois, 1999 to 2009.
作者信息
Nicolson Norman G, Schwulst Steven, Esposito Thomas A, Crandall Marie L
机构信息
Division of Trauma and Critical Care, Department of Surgery, Northwestern University Feinberg School of Medicine, 676 N Saint Clair, Suite 650, Chicago, IL 60611, USA.
Division of Trauma and Critical Care, Department of Surgery, Northwestern University Feinberg School of Medicine, 676 N Saint Clair, Suite 650, Chicago, IL 60611, USA.
出版信息
Am J Surg. 2015 Oct;210(4):720-3. doi: 10.1016/j.amjsurg.2015.05.007. Epub 2015 Jun 29.
BACKGROUND
Outcomes in adults who undergo resuscitative thoracotomy are poor. Few studies have examined the procedure's use in pediatric trauma.
METHODS
The Illinois State Trauma Registry was queried for thoracotomy performed in the emergency department from 1999 to 2009, for patients aged 0 to 15. Injury mechanism, vital signs, and mortality were examined while controlling for injury severity.
RESULTS
Resuscitative thoracotomy was infrequently performed in pediatric trauma (n = 25; 2.3/year). Most patients had suffered penetrating injury. Patients who underwent resuscitative thoracotomy were in extremis, with only 17% demonstrating signs of life upon presentation. Although 6 patients (24%) survived initially, only 2 (8%) survived to hospital discharge.
CONCLUSIONS
Resuscitative thoracotomy was rarely performed in children in Illinois emergency departments. Survival is low for thoracotomy in the emergency department, but some patients who presented with penetrating injuries did have positive outcomes, supporting a continued role for the procedure in select cases.
背景
接受复苏性开胸手术的成年患者预后较差。很少有研究探讨该手术在儿童创伤中的应用。
方法
查询伊利诺伊州创伤登记处1999年至2009年在急诊科对0至15岁患者进行开胸手术的情况。在控制损伤严重程度的同时，检查损伤机制、生命体征和死亡率。
结果
复苏性开胸手术在儿童创伤中很少进行（n = 25；每年2.3例）。大多数患者遭受穿透性损伤。接受复苏性开胸手术的患者情况危急，就诊时仅有17%有生命体征。虽然6例患者（24%）最初存活，但只有2例（8%）存活至出院。
结论
伊利诺伊州急诊科很少对儿童进行复苏性开胸手术。急诊科开胸手术的存活率较低，但一些有穿透性损伤的患者确实有良好预后，支持该手术在某些特定病例中继续发挥作用。
Zotero 插件