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小儿胸部创伤的特点:在建立区域性创伤中心前后的观察。

Characteristics of pediatric thoracic trauma: in view of before and after the establishment of a regional trauma center.

机构信息

Regional Trauma Center, Wonju Severance Christian Hospital, Wonju, Republic of Korea.

Department of Surgery, Yonsei University Wonju College of Medicine, Wonju, Republic of Korea.

出版信息

Eur J Trauma Emerg Surg. 2022 Feb;48(1):195-204. doi: 10.1007/s00068-021-01658-4. Epub 2021 Apr 3.

Abstract

PURPOSE

Pediatric thoracic trauma differs from those of adult in terms of the small anatomy and rapid tissue recovery. Therefore, it is important to know the characteristics of the pediatric thoracic trauma to improve treatment results. In addition, this study examined the changes in pediatric thoracic trauma features and results from the establishment of a level 1 regional trauma center.

METHODS

Data of 168 patients' ≤ 15 years old diagnosed with thoracic trauma between 2008 and 2019 were retrospectively analyzed.

RESULTS

Pedestrian traffic accidents were the most common cause of chest injury. The average injury severity score was 17.1 ± 12.4 and the average pediatric trauma score was 5.6 ± 4.1. Lung contusion was the most common in 134 cases. There were 48 cases of closed thoracostomy. There was one thoracotomy for cardiac laceration, one case for extracorporeal membranous oxygenation, and six cases for embolization. Of all, 25 patients died, providing a mortality rate of 14.9%. In addition, independent risk factors of in-hospital mortality were hemopneumothorax and cardiac contusion. Since 2014, when the level 1 regional trauma center was established, more severely injured thoracic trauma patients came. However, the mortality was similar in the two periods.

CONCLUSIONS

Understanding the clinical features of pediatric thoracic trauma patients can help in efficient treatment. In addition, as the severity of pediatric thoracic trauma patients has increased due to the establishment of the regional trauma center, so pediatric trauma center should be organized in regional trauma center to improve the outcomes of pediatric thoracic trauma.

摘要

目的

小儿胸外伤在解剖学上较小,组织恢复迅速,与成人不同。因此,了解小儿胸外伤的特点,对提高治疗效果很重要。此外,本研究通过建立 1 级区域创伤中心,探讨小儿胸外伤特点及结果的变化。

方法

回顾性分析 2008 年至 2019 年诊断为胸外伤的 168 例≤15 岁患者的数据。

结果

行人交通事故是胸部损伤最常见的原因。平均损伤严重度评分(ISS)为 17.1±12.4,平均小儿创伤评分(PTS)为 5.6±4.1。134 例患者为肺挫伤,48 例行闭式胸腔引流术。1 例开胸术治疗心脏裂伤,1 例体外膜肺氧合,6 例栓塞。共有 25 例死亡,死亡率为 14.9%。此外,院内死亡的独立危险因素是血气胸和心脏挫伤。自 2014 年建立 1 级区域创伤中心以来,更多严重胸部创伤的患者前来就诊。然而,两个时期的死亡率相似。

结论

了解小儿胸外伤患者的临床特点有助于进行有效的治疗。此外,由于区域创伤中心的建立,小儿胸外伤患者的严重程度增加,因此应在区域创伤中心组织小儿创伤中心,以提高小儿胸外伤的治疗效果。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/fa8b/8825618/a09bf39f357e/68_2021_1658_Fig1_HTML.jpg

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