烧伤患者眶隔综合征的诊断与处理--系统综述。

IF 1.5 4区 医学 Q3 CRITICAL CARE MEDICINE
Nathan Makarewicz, David Perrault, Priscila Cevallos, Clifford C Sheckter
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引用次数: 0

摘要

眶隔综合征是急性烧伤的一种并发症,人们对其了解甚少。本系统性综述旨在总结烧伤患者眶隔综合征的相关文献,以提供更详细的风险因素信息并指导对这一病症的治疗。根据《系统综述和荟萃分析首选报告项目》指南,我们于 2023 年 6 月对 PubMed、Embase 和 Cochrane 图书馆数据库进行了系统综述。研究质量采用两种经过验证的评分系统进行评估。删除重复文章后,共审查了 303 篇文章,其中 8 篇符合纳入标准。所有文献均为回顾性研究。大多数研究认为眼压>30-40mmHg可诊断为眶隔综合征。共报告了 60 例眼眶隔室综合征病例。眶隔综合征最常在烧伤后 24 小时内发生。烧伤的平均体表总面积为 58.7%;24 小时平均抢救量为 6.01 cc/kg/%烧伤体表总面积;86.5% 的病例为眶周烧伤。手术减压总是从外侧泪囊切开术开始。如果压力不能立即降低,则进行泪囊切开术。按照纽卡斯尔-渥太华评分中位数计算的研究质量从 38.9% 到 94.4% 不等(中位数为 66.7%)。对 OCS 进行手术减压的精确阈值仍然存在争议;但是,眼压>30-40mmHg 就需要进行干预。烧伤外科医生/营养师应了解这种威胁视力的并发症的风险因素,并采取适当措施。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Diagnosis and Management of Orbital Compartment Syndrome in Burn Patients-A Systematic Review.

Orbital compartment syndrome is a poorly understood complication of acute burns. The purpose of this systematic review is to summarize the literature describing orbital compartment syndrome in patients with burns to provide greater detail on risk factors and guide the management of this morbid condition. A systematic review of the PubMed, Embase, and Cochrane Library databases was performed in June 2023 according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Study quality was assessed using 2 validated scoring systems. After removing duplicates, 303 unique articles were reviewed and 8 met the inclusion criteria. All publications were retrospective. Most studies considered intraocular pressure >30-40 mmHg as diagnostic for orbital compartment syndrome. In total, 60 unique cases of orbital compartment syndrome were reported. Orbital compartment syndrome occurred most frequently within 24 h postburn. The mean total body surface area of burn was 58.7%; the mean 24-h resuscitation volume was 6.01 cc/kg/%total burn surface area; and 86.5% of cases had periorbital burns. Surgical decompression always starts with lateral canthotomy. When pressures were not immediately reduced, cantholysis was performed. Study quality per median Newcastle-Ottawa Scores ranged from 38.9% to 94.4% (median 66.7%). A precise threshold for surgical decompression of orbital compartment syndrome remains conflicted; however, increased intraocular pressure > 30-40 mmHg warrants intervention. Burn surgeons/intensivists should be aware of the risk factors for this vision-threatening complication and act appropriately.

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来源期刊
CiteScore
2.60
自引率
21.40%
发文量
535
审稿时长
4-8 weeks
期刊介绍: Journal of Burn Care & Research provides the latest information on advances in burn prevention, research, education, delivery of acute care, and research to all members of the burn care team. As the official publication of the American Burn Association, this is the only U.S. journal devoted exclusively to the treatment and research of patients with burns. Original, peer-reviewed articles present the latest information on surgical procedures, acute care, reconstruction, burn prevention, and research and education. Other topics include physical therapy/occupational therapy, nutrition, current events in the evolving healthcare debate, and reports on the newest computer software for diagnostics and treatment. The Journal serves all burn care specialists, from physicians, nurses, and physical and occupational therapists to psychologists, counselors, and researchers.
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