在混合急诊室采用胸主动脉腔内修复术治疗钝性胸主动脉损伤：一例报告
Blunt thoracic aortic injury treated with thoracic endovascular aortic repair in hybrid emergency room: A case report.
作者信息
Kondo Mayo, Nishimura Takeshi, Maemura Saki, Ijuin Shinichi, Nakayama Haruki, Matsuyama Shigenari, Ishihara Satoshi
机构信息
Department of Emergency and Critical Care Medicine, Hyogo Emergency Medical Center, 1-3-1 Wakinohamakaigandori, Chuo-ku, Kobe, Hyogo 651-0073, Japan.
出版信息
Trauma Case Rep. 2025 Jan 4;55:101124. doi: 10.1016/j.tcr.2025.101124. eCollection 2025 Feb.
BACKGROUND
Hybrid emergency rooms (ERs) allow computed tomography (CT) scanning, interventional radiology, and surgery all in the same suite. Severe trauma patients with blunt thoracic aortic injury (BTAI) require rapid diagnosis and treatment. Hybrid ERs allow the potential for clinicians to implement multiple therapeutic procedures, including thoracic endovascular aortic repair (TEVAR), for these types of conditions without the need to transport the patients.
CASE PRESENTATION
A 35-year-old man sustained multiple injuries after a motor vehicle accident and was transferred to our hospital in shock status. CT revealed a grade IV BTAI rupturing into the thoracic cavity and pelvic fracture. Soon after preperitoneal pelvic packing and transcatheter arterial embolization for pelvic fracture, TEVAR was performed in the hybrid ER without transporting the patient. The patient was transferred to a rehabilitation hospital on postoperative day 41.
CONCLUSION
Hybrid ERs enable clinicians to perform all life-saving procedures, including stent grafting for traumatic patients with aortic injuries, in the same place.
背景
混合型急诊室可在同一区域内进行计算机断层扫描（CT）、介入放射学检查及手术。钝性胸主动脉损伤（BTAI）的严重创伤患者需要快速诊断和治疗。混合型急诊室使临床医生有可能在不转运患者的情况下，针对此类病症实施包括胸主动脉腔内修复术（TEVAR）在内的多种治疗手段。
病例介绍
一名35岁男性在机动车事故后多处受伤，以休克状态被转送至我院。CT显示为IV级BTAI，破裂进入胸腔且伴有骨盆骨折。在对骨盆骨折进行腹膜前骨盆填塞和经导管动脉栓塞后不久，患者在混合型急诊室内接受了TEVAR治疗，未进行转运。患者于术后第41天转至康复医院。
结论
混合型急诊室使临床医生能够在同一地点为包括主动脉损伤的创伤患者进行支架植入术在内的所有挽救生命的操作。
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