Kushida Yoshihiro, Takeuchi Ikuto, Muramatsu Ken-Ichi, Nagasawa Hiroki, Jitsuiki Kei, Ohsaka Hiromichi, Ishikawa Kouhei, Yanagawa Youichi
Department of Acute Critical Care Medicine, Shizuoka Hospital, Juntendo University, Izunokuni City, Shizuoka, Japan.
Department of Acute Critical Care Medicine, Shizuoka Hospital, Juntendo University, Izunokuni City, Shizuoka, Japan.
Air Med J. 2023 Jan-Feb;42(1):24-27. doi: 10.1016/j.amj.2022.11.002. Epub 2022 Nov 18.
We compared the outcomes of patients with tube thoracostomy for chest trauma between the prehospital and inhospital settings.
The subjects were then divided into 2 groups: the prehospital group, which included subjects who underwent tube thoracostomy in the prehospital setting, and the inhospital group, which included subjects who underwent tube thoracostomy in the inhospital setting. The variables were compared between the 2 groups.
There were no significant differences between the 2 groups with regard to gender, age, history, mechanism of injury, infusion of antibiotics, white blood cell count, duration of insertion of a chest drain, mechanical ventilation, complication of drain infection, duration of admission, or final outcome. However, the Injury Severity Score, maximum C-reactive protein level, and maximum temperature during hospitalization in the prehospital group (n = 15) were significantly greater than those in the inhospital group (n = 119).
The present study suggested that thoracostomy performed by physicians in the prehospital setting was safe and did not have an increased risk of infection. In addition, thoracostomy for chest injury in the prehospital setting suggested an improvement in the likelihood of a survival outcome.
我们比较了院前和院内环境下胸部创伤患者行胸腔闭式引流术的结果。
将受试者分为两组：院前组，包括在院前环境下接受胸腔闭式引流术的受试者；院内组，包括在院内环境下接受胸腔闭式引流术的受试者。比较两组之间的变量。
两组在性别、年龄、病史、损伤机制、抗生素输注、白细胞计数、胸腔引流管插入时间、机械通气、引流感染并发症、住院时间或最终结局方面无显著差异。然而，院前组（n = 15）的损伤严重程度评分、住院期间最高C反应蛋白水平和最高体温显著高于院内组（n = 119）。
本研究表明，医生在院前环境下行胸腔闭式引流术是安全的，且感染风险未增加。此外，院前环境下胸部损伤行胸腔闭式引流术提示生存结局可能性有所改善。
