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创伤患者长时间腹部填塞与发病率和死亡率增加相关。

Prolonged abdominal packing for trauma is associated with increased morbidity and mortality.

作者信息

Abikhaled J A, Granchi T S, Wall M J, Hirshberg A, Mattox K L

机构信息

Cora and Webb Mading Department of Surgery, Baylor College of Medicine, Houston, TX 77030, USA.

出版信息

Am Surg. 1997 Dec;63(12):1109-12; discussion 1112-3.

PMID:9393261
Abstract

Abdominal packing and planned reoperation is a lifesaving technique for temporary control of hemorrhage in severely injured patients. Morbidity and mortality in this group of patients, however, remain significant. It is unclear whether the duration of packing impacts upon outcome. The purpose of this study is to evaluate the abscess, sepsis, and mortality rates associated with duration of abdominal packing. The records of 35 patients treated with abdominal packing between July 1994 and December 1995 who survived to reoperation were retrospectively reviewed. Evaluation included age; sex; mechanism; injuries; Abdominal Trauma Index; duration of packing; survival; and presence of abscess, sepsis or other infections. Patients packed for a total of 72 hours or less had lower abscess, sepsis, and mortality rates than those packed for more than 72 hours. The differences in abscess rate and mortality were statistically significant (P < 0.05). The Abdominal Trauma Index and mechanism of injury were similar for the two groups. Based on these results, we conclude that although abdominal packing is a useful technique in the severely injured patient, it is associated with greater morbidity and mortality when the duration of packing exceeds 72 hours.

摘要

腹部填塞及计划性再次手术是一种用于严重创伤患者临时控制出血的挽救生命的技术。然而,这类患者的发病率和死亡率仍然很高。目前尚不清楚填塞持续时间是否会影响预后。本研究的目的是评估与腹部填塞持续时间相关的脓肿、脓毒症及死亡率。对1994年7月至1995年12月期间接受腹部填塞治疗且存活至再次手术的35例患者的记录进行回顾性分析。评估内容包括年龄、性别、致伤机制、损伤情况、腹部创伤指数、填塞持续时间、存活情况以及是否存在脓肿、脓毒症或其他感染。填塞总时长为72小时及以内的患者,其脓肿、脓毒症及死亡率低于填塞时长超过72小时的患者。脓肿发生率和死亡率的差异具有统计学意义(P < 0.05)。两组患者的腹部创伤指数和致伤机制相似。基于这些结果,我们得出结论:尽管腹部填塞对严重创伤患者是一种有用的技术,但当填塞持续时间超过72小时时,其会导致更高的发病率和死亡率。

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