The Association between Chance Fractures and Intra-abdominal Injuries Revisited: A Multicenter Review
The Association between Chance Fractures and Intra-abdominal Injuries Revisited: A Multicenter Review
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重新审视偶然性骨折与腹内损伤之间的关联：多中心综述
DOI：
10.1177/000313480507100514
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发表时间：
2005
期刊：
影响因子：
--
通讯作者：
Jan Price
中科院分区：
文献类型：
--
作者：
A. Tyroch;Emmett L. Mcguire;S. McLean;R. Kozar;Keith A Gates;K. Kaups;C. Cook;S. Cowgill;J. Griswold;Larry A Sue;M. Craun;Jan Price
据报道，Chance骨折与腹腔内损伤之间的相关性高达89%。由于之前的研究都是小系列或病例报告，因此我们进行了一项多中心回顾，以了解Chance骨折与腹腔内损伤之间的真正相关性以及诊断趋势。来自7个创伤中心的创伤登记数据、医疗记录和放射学报告被用于描述79例创伤患者的Chance骨折。腹部评估的最初方法是计算机断层扫描（CT）扫描（79%），临床检查（16%）和诊断性腹腔灌洗（DPL）（5%）。26例（33%）患者有腹腔内损伤，其中中空脏器损伤占主导地位（22%）。20例患者（25%）接受了剖腹手术。存在腹壁挫伤和使用汽车约束是高度预测腹腔内损伤和剖腹手术的需要。Chance骨折和腹腔内损伤之间的相关性并不像以前报道的那么高。CT扫描已成为评估Chance骨折患者腹腔的主要方式，而DPL的作用已经减弱。
The association between Chance fractures and intra-abdominal injuries is reported to be as high as 89 per cent. Because prior studies were small series or case reports, we conducted a multicenter review to learn the true association between Chance fractures and intra-abdominal injuries as well as diagnostic trends. Trauma registry data, medical records, and radiology reports from 7 trauma centers were used to characterize 79 trauma patients with Chance fractures. Initial methods of abdominal assessment were computed tomography (CT) scan (79%), clinical examination (16%), and diagnostic peritoneal lavage (DPL) (5%). Twenty-six (33%) patients had intraabdominal injuries of which hollow viscus injuries predominated (22%). Twenty patients (25%) underwent laparotomy. The presence of an abdominal wall contusion and automobile restraint use were highly predictive of intra-abdominal injury and the need for laparotomy. The association between a Chance fracture and intra-abdominal injury is not as high as previously reported. CT scan has become the primary modality to assess the abdominal cavity of patients with Chance fractures, whereas the role of DPL has diminished.