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[胸部创伤与大血管损伤的干预措施]

[Intervention for Chest Trauma and Large Vessel Injury].

作者信息

Lee Hojun, Kwon Hoon, Kim Chang Won, Hwangbo Lee

出版信息

J Korean Soc Radiol. 2023 Jul;84(4):809-823. doi: 10.3348/jksr.2023.0035. Epub 2023 Jul 14.

Abstract

Trauma is an injury to the body that involves multiple anatomical and pathophysiological changes caused by forces acting from outside the body. The number of patients with trauma is increasing as our society becomes more sophisticated. The importance and demand of traumatology are growing due to the development and spread of treatment and diagnostic technologies. In particular, damage to the large blood vessels of the chest can be life-threatening, and the sequelae are often severe; therefore, diagnostic and therapeutic methods are becoming increasingly important. Trauma to non-aortic vessels of the thorax and aorta results in varying degrees of physical damage depending on the mechanism of the accident and anatomical damage involved. The main damage is hemorrhage from non-aortic vessels of the thorax and aorta, accompanied by hemodynamic instability and coagulation disorders, which can be life-threatening. Immediate diagnosis and rapid therapeutic access can often improve the prognosis. The treatment of trauma can be surgical or interventional, depending on the patient's condition. Among them, interventional procedures are increasingly gaining popularity owing to their convenience, rapidity, and high therapeutic effectiveness, with increasing use in more trauma centers worldwide. Typical interventional procedures for patients with thoracic trauma include embolization for non-aortic injuries and thoracic endovascular aortic repair for aortic injuries. These procedures have many advantages over surgical treatments, such as fewer internal or surgical side effects, and can be performed more quickly than surgical procedures, contributing to improved outcomes for patients with trauma.

摘要

创伤是指身体受到的损伤,涉及由体外作用力引起的多种解剖学和病理生理学变化。随着我们的社会变得更加复杂,创伤患者的数量正在增加。由于治疗和诊断技术的发展与普及,创伤学的重要性和需求也在不断增长。特别是,胸部大血管的损伤可能危及生命,且后遗症往往很严重;因此,诊断和治疗方法变得越来越重要。胸部非主动脉血管和主动脉的创伤会根据事故机制和所涉及的解剖损伤导致不同程度的身体损害。主要损害是胸部非主动脉血管和主动脉出血,伴有血流动力学不稳定和凝血障碍,这可能危及生命。及时诊断和快速治疗通常可以改善预后。创伤的治疗可以是手术治疗或介入治疗,具体取决于患者的病情。其中,介入手术因其便利性、快速性和高治疗效果而越来越受欢迎,在全球越来越多的创伤中心得到了更多应用。胸部创伤患者的典型介入手术包括针对非主动脉损伤的栓塞术和针对主动脉损伤的胸段血管腔内主动脉修复术。这些手术相对于手术治疗有许多优点,如较少的内部或手术副作用,并且比手术程序执行得更快,有助于改善创伤患者的治疗效果。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/bea6/10407064/539c7fe35538/jksr-84-809-g001.jpg

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