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乞力马扎罗基督教医疗中心胸部损伤的模式、管理及结果

Pattern, Management, and Outcomes of Chest Injury At Kilimanjaro Christian Medical Centre.

作者信息

Mduma Elias, Chugulu Samwel, Msuya David, Sakita Francis, Fabrice L Ele Mutombo

机构信息

General Surgery, Kilimanjaro Christian Medical Centre.

Kilimanjaro Christian Medical University College.

出版信息

East Afr Health Res J. 2023;7(1):94-102. doi: 10.24248/eahrj.v7i1.714. Epub 2023 Jul 12.

Abstract

BACKGROUND

Chest trauma is a major cause of morbidity and mortality in the region. Lacking data in our environment has been a challenging part of knowing the burden of the problem. Long hospital stays and associated injuries are an essential measure of morbidity. The study results will provide a basis for planning prevention strategies and establishment of treatment protocols.

OBJECTIVES

To determine the prevalence, pattern, and management outcomes of chest injury patients at Kilimanjaro Christian Medical Center (KCMC), a Tertiary Hospital in Northern zone Tanzania from October 2021 to April 2022.

METHODOLOGY

A hospital-based cross-sectional study was conducted among patients with chest injuries who were admitted and managed at Tertiary Hospital Northern Zone (Kilimanjaro Christian Medical Center-KCMC) in the Emergency medicine and General Surgery departments. Using a designated data collection tool, details of the mechanism of injury, radiological and laboratory investigations, management, and outcomes were recorded.

RESULTS

A total of 114 chest injury patients were studied. Males outnumbered females by a ratio of 7.14:1. Their ages ranged from 2 to 83 years (mean = 36.18 years). The Majority of patients (95.58%) sustained blunt injuries. Road traffic crush was the most common cause of injuries affecting 65.79% of patients. Lung contusion, hemothorax, and rib fractures were the most common type of injuries accounting for 54.4%, 27.2%, and 21.1%, respectively. Associated injuries were noted in 85.7% of patients, and head injury (60.5%) was found in most patients. The Majority of patients (60.5%) were treated successfully with a non-operative approach. Underwater seal drainage was performed at (38.9%). One Patient (0.9%) underwent a thoracotomy. 14% of patients had complications of surgical site infection, and 69% were found in the Majority of patients. The median length of hospital stay was 4.5 days. The mortality rate was 21.

CONCLUSION

Motor traffic crash was the principal cause of chest trauma. Young male patients were most affected by chest trauma and the majority of patients were treated conservatively. Chest X-ray remains to be the main imaging modality for diagnosing thoracic trauma lesions. Associated injuries such as head injuries, were found to contribute to a high mortality rate.

摘要

背景

胸部创伤是该地区发病和死亡的主要原因。在我们所处的环境中,缺乏相关数据一直是了解该问题负担的一个具有挑战性的方面。长时间住院和相关损伤是发病率的一项重要衡量指标。研究结果将为制定预防策略和建立治疗方案提供依据。

目的

确定2021年10月至2022年4月期间,坦桑尼亚北部地区三级医院乞力马扎罗基督教医疗中心(KCMC)胸部损伤患者的患病率、模式及治疗结果。

方法

在三级医院北部地区(乞力马扎罗基督教医疗中心-KCMC)急诊科和普通外科收治并接受治疗的胸部损伤患者中开展了一项基于医院的横断面研究。使用指定的数据收集工具,记录损伤机制、放射学和实验室检查、治疗及结果的详细信息。

结果

共研究了114例胸部损伤患者。男性与女性的比例为7.14:1。他们的年龄在2岁至83岁之间(平均 = 36.18岁)。大多数患者(95.58%)遭受钝性损伤。道路交通挤压伤是最常见的损伤原因,影响了65.79%的患者。肺挫伤、血胸和肋骨骨折是最常见的损伤类型,分别占54.4%、27.2%和21.1%。85.7%的患者存在相关损伤,大多数患者(60.5%)存在头部损伤。大多数患者(60.5%)通过非手术方法成功治疗。38.9%的患者进行了胸腔闭式引流。1例患者(0.9%)接受了开胸手术。14%的患者发生手术部位感染并发症,大多数患者(69%)出现该情况。中位住院时间为4.5天。死亡率为21。

结论

机动车交通事故是胸部创伤的主要原因。年轻男性患者受胸部创伤影响最大,大多数患者接受保守治疗。胸部X线仍然是诊断胸外伤病变的主要影像学检查方法。发现如头部损伤等相关损伤导致高死亡率。

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