Permissive hypotension is a medical strategy that involves intentionally maintaining lower-than-normal blood pressure in certain situations,
{"title":"Permissive Hypotension and Permissive Haemorrhage – Are They Necessary Evils of Trauma?","authors":"Mansoor Khan, Boris Kessel","doi":"10.26676/jevtm.307","DOIUrl":"https://doi.org/10.26676/jevtm.307","url":null,"abstract":"Permissive hypotension is a medical strategy that involves intentionally maintaining lower-than-normal blood pressure in certain situations,","PeriodicalId":41233,"journal":{"name":"Journal of EndoVascular Resuscitation and Trauma Management","volume":"30 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135825362","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Adenauer Marinho de Oliveira Góes Junior, Emily Saboia Moura Rodrigues
Patients may sustain vascular injuries in rural areas or isolated locations, which are very common in the vast area of the Amazon rainforest. In situations like this, patients may take many hours, or even days, to get access to hospitals capable of dealing with these potentially lethal injuries, arriving in severe conditions that may require damage control strategies. Among the currently available techniques for damage control resuscitation and damage control surgery, the endovascular balloon occlusion of the aorta (REBOA) and temporary vascular shunts play an important role, but appropriate devices are often unavailable; in such scenarios, surgeons’ expertise on how to improvise devices, using more accessible materials, can be lifesaving. This paper presents a case of femoral vessel injury in a patient who required REBOA and vascular shunt improvisation; discussions regarding possible improvisation strategies are provided and technical steps on how to implement them are described.
{"title":"Damage Control Strategies For Vascular Injuries – A Report From The Amazon","authors":"Adenauer Marinho de Oliveira Góes Junior, Emily Saboia Moura Rodrigues","doi":"10.26676/jevtm.306","DOIUrl":"https://doi.org/10.26676/jevtm.306","url":null,"abstract":"Patients may sustain vascular injuries in rural areas or isolated locations, which are very common in the vast area of the Amazon rainforest. In situations like this, patients may take many hours, or even days, to get access to hospitals capable of dealing with these potentially lethal injuries, arriving in severe conditions that may require damage control strategies. Among the currently available techniques for damage control resuscitation and damage control surgery, the endovascular balloon occlusion of the aorta (REBOA) and temporary vascular shunts play an important role, but appropriate devices are often unavailable; in such scenarios, surgeons’ expertise on how to improvise devices, using more accessible materials, can be lifesaving. This paper presents a case of femoral vessel injury in a patient who required REBOA and vascular shunt improvisation; discussions regarding possible improvisation strategies are provided and technical steps on how to implement them are described.","PeriodicalId":41233,"journal":{"name":"Journal of EndoVascular Resuscitation and Trauma Management","volume":"31 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135825355","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
As experience using resuscitative endovascular balloon occlusion of the aorta (REBOA) has expanded over the past few years, best practices for implementing a REBOA program have emerged. Early practice was single-surgeon focused, but we have learned that a team approach to REBOA practice is common in successful programs. Key components of our contemporary team approach are defining a patient selection algorithm, uniform acceptance of early CFA access, full team training, regular case reviews, and implementation of a process improvement program. This team approach to REBOA has resulted in numerous benefits for trauma patients with, most importantly, a significantly decreased time to definitive hemorrhage control. Here, we describe our experience and outcomes as a Level 1 Trauma Center implementing a REBOA program, shifting our hemorrhage control paradigm from reactive to proactive, and subsequently improving time to both temporary and definitive hemorrhage control maneuvers.
{"title":"A Pilot Study of Proactive Team REBOA to Avoid Delays to Definitive Care","authors":"M Chance Spalding, Urmil Pandya","doi":"10.26676/jevtm.297","DOIUrl":"https://doi.org/10.26676/jevtm.297","url":null,"abstract":"As experience using resuscitative endovascular balloon occlusion of the aorta (REBOA) has expanded over the past few years, best practices for implementing a REBOA program have emerged. Early practice was single-surgeon focused, but we have learned that a team approach to REBOA practice is common in successful programs. Key components of our contemporary team approach are defining a patient selection algorithm, uniform acceptance of early CFA access, full team training, regular case reviews, and implementation of a process improvement program. This team approach to REBOA has resulted in numerous benefits for trauma patients with, most importantly, a significantly decreased time to definitive hemorrhage control. Here, we describe our experience and outcomes as a Level 1 Trauma Center implementing a REBOA program, shifting our hemorrhage control paradigm from reactive to proactive, and subsequently improving time to both temporary and definitive hemorrhage control maneuvers.","PeriodicalId":41233,"journal":{"name":"Journal of EndoVascular Resuscitation and Trauma Management","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135825351","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
We present the case of a 37-year-old patient admitted after a motorcycle crash. He was hemodynamically stable.
{"title":"Endovascular Embolization of a Bleeding Liver","authors":"Anna Stene Hurtsén","doi":"10.26676/jevtm.300","DOIUrl":"https://doi.org/10.26676/jevtm.300","url":null,"abstract":"We present the case of a 37-year-old patient admitted after a motorcycle crash. He was hemodynamically stable.","PeriodicalId":41233,"journal":{"name":"Journal of EndoVascular Resuscitation and Trauma Management","volume":"22 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135825357","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
D. Ege, M. Avcil, Y. E. Özlüer, Çağaç Yetiş, E. Sayın, Kezban ŞEKER YAŞAR, Ertuğ Dinçer
Background: Trauma is the leading cause of death in those aged 1–44 years; nearly half of these fatalities are due to bleeding. As resuscitative endovascular balloon occlusion of the aorta (REBOA) and other endovascular resuscitation and trauma management (EVTM) methods became known in Turkey, they started to arouse interest. The main objective of this study is to reveal the impressions of emergency medicine (EM) doctors about EVTM and REBOA application possibilities, and the secondary objective is to determine the issues that are limiting their spread.Methods: We conducted a 22-question cross-sectional survey via e-mail between 1 January and 1 April 2020. The questions were formulated to be closed-ended, semi-closed-ended, and open-ended. The evaluation questions utilized 3- and 5-point Likert scales and Yes/No questions. EM specialists, residents, consultants, and physicians working as emergency department (ED) directors in Turkey were included. EM specialists working in units other than EDs and specialists from other branches were excluded.Results: Among the 512 people contacted for this study, 132 agreed to participate. The numbers of participants that were aware of REBOA and EVTM were 114 and 99, respectively. Participants thought that femoral vascular access, extracorporeal membrane oxygenation (ECMO), and REBOA were more applicable in EDs (median 4, 4, and 4.5, respectively; interquartile range 1–5). Participants considered lack of knowledge and skills and lack of equipment as barriers to REBOA (median 5 and 5, respectively).Conclusions: To disseminate EVTM practices in Turkey, projects should be conducted primarily to address lack of knowledge, skills, and equipment.
{"title":"Assessing the Awareness of EVTM Practices Among Emergency Medicine Physicians in Turkey","authors":"D. Ege, M. Avcil, Y. E. Özlüer, Çağaç Yetiş, E. Sayın, Kezban ŞEKER YAŞAR, Ertuğ Dinçer","doi":"10.26676/jevtm.288","DOIUrl":"https://doi.org/10.26676/jevtm.288","url":null,"abstract":"Background: Trauma is the leading cause of death in those aged 1–44 years; nearly half of these fatalities are due to bleeding. As resuscitative endovascular balloon occlusion of the aorta (REBOA) and other endovascular resuscitation and trauma management (EVTM) methods became known in Turkey, they started to arouse interest. The main objective of this study is to reveal the impressions of emergency medicine (EM) doctors about EVTM and REBOA application possibilities, and the secondary objective is to determine the issues that are limiting their spread.Methods: We conducted a 22-question cross-sectional survey via e-mail between 1 January and 1 April 2020. The questions were formulated to be closed-ended, semi-closed-ended, and open-ended. The evaluation questions utilized 3- and 5-point Likert scales and Yes/No questions. EM specialists, residents, consultants, and physicians working as emergency department (ED) directors in Turkey were included. EM specialists working in units other than EDs and specialists from other branches were excluded.Results: Among the 512 people contacted for this study, 132 agreed to participate. The numbers of participants that were aware of REBOA and EVTM were 114 and 99, respectively. Participants thought that femoral vascular access, extracorporeal membrane oxygenation (ECMO), and REBOA were more applicable in EDs (median 4, 4, and 4.5, respectively; interquartile range 1–5). Participants considered lack of knowledge and skills and lack of equipment as barriers to REBOA (median 5 and 5, respectively).Conclusions: To disseminate EVTM practices in Turkey, projects should be conducted primarily to address lack of knowledge, skills, and equipment. ","PeriodicalId":41233,"journal":{"name":"Journal of EndoVascular Resuscitation and Trauma Management","volume":" ","pages":""},"PeriodicalIF":0.4,"publicationDate":"2023-09-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42985273","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Amr Abdelghaffar Hanfy Mahmoud, Mohamed AbdelSamie Khalek Elbahat
Background: Popliteal artery injuries carry a risk of amputation rate ranging from 9.7% to 28%. The mangled extremity score system (MESS) was originally authenticated in only 26 patients and it was concluded that an MESS ≥ 7 equated to a 100% rate of amputation. In this study we add the effects of combined arterial venous injuries and combined arterial venous and nerve injuries to the risk of amputation and correlate them with the MESS.Methods: This is a retrospective single arm cohort study conducted using 25 patients included between 1 January 2020 and 1 January 2023 at two hospitals, Ain Shams University Hospital and Shebin Elkoom Teaching Hospital. The study defined two groups: the amputation and non-amputation groups. It assessed the validity of the MESS to predict limb salvage in cases of traumatic popliteal artery injuries.Results: The overall rate of amputation was 64%. Patients presenting with MESS ≥ 8 had an amputation rate of 25%, while patients with MESS ≥ 9 had an amputation rate of 75%. Patients presenting with combined popliteal artery and vein or combined artery, vein and nerve injury had a 100% rate of amputation (MESS ≥ 8). There was no 30-day mortality.Conclusions: MESS ≥ 9 carries a high risk of amputation (75%). Combined arterial and venous injuries or arterial, venous and nerve injuries, which already have a high MESS, also carry a high risk of amputation. All of them could be predictors of limb salvage in popliteal artery injury.
{"title":"Validity of Mangled Extremity Score System to Predict Limb Salvage on Cases of Traumatic Popliteal Artery Injuries: A Case Series and Review of the Literature","authors":"Amr Abdelghaffar Hanfy Mahmoud, Mohamed AbdelSamie Khalek Elbahat","doi":"10.26676/jevtm.283","DOIUrl":"https://doi.org/10.26676/jevtm.283","url":null,"abstract":"Background: Popliteal artery injuries carry a risk of amputation rate ranging from 9.7% to 28%. The mangled extremity score system (MESS) was originally authenticated in only 26 patients and it was concluded that an MESS ≥ 7 equated to a 100% rate of amputation. In this study we add the effects of combined arterial venous injuries and combined arterial venous and nerve injuries to the risk of amputation and correlate them with the MESS.Methods: This is a retrospective single arm cohort study conducted using 25 patients included between 1 January 2020 and 1 January 2023 at two hospitals, Ain Shams University Hospital and Shebin Elkoom Teaching Hospital. The study defined two groups: the amputation and non-amputation groups. It assessed the validity of the MESS to predict limb salvage in cases of traumatic popliteal artery injuries.Results: The overall rate of amputation was 64%. Patients presenting with MESS ≥ 8 had an amputation rate of 25%, while patients with MESS ≥ 9 had an amputation rate of 75%. Patients presenting with combined popliteal artery and vein or combined artery, vein and nerve injury had a 100% rate of amputation (MESS ≥ 8). There was no 30-day mortality.Conclusions: MESS ≥ 9 carries a high risk of amputation (75%). Combined arterial and venous injuries or arterial, venous and nerve injuries, which already have a high MESS, also carry a high risk of amputation. All of them could be predictors of limb salvage in popliteal artery injury.","PeriodicalId":41233,"journal":{"name":"Journal of EndoVascular Resuscitation and Trauma Management","volume":" ","pages":""},"PeriodicalIF":0.4,"publicationDate":"2023-07-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42111976","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
G. Lassandro, Giorgio Mazzotta, S. Picchi, G. Sarti, F. Spinetti, A. Corvino, Giampaolo Santini, F. Tamburro
Aorto-enteric fistula is defined as a communication between the aorta and the gastrointestinal tract. It is a rare but life-threatening condition associated with almost 100% mortality without prompt surgical intervention. The most common type of aorto-enteric fistula is the aorto-duodenal fistula. Upper gastrointestinal bleeding is the most common presentation, ranging from a minor haemorrhage to massive life-threatening bleeding.Computed tomography angiography is the first-line modality for imaging evaluation of suspected aorto-enteric fistula. Surgical treatment of this condition may be open aortic repair, in situ graft replacement if present, or placement of an extra-anatomical bypass.We present our case of a 71-year-old woman with infected aorto-aortic graft complicated by aorto-duodenal fistula. The patient was successfully treated by aortic Zenith Cook cuff endovascular placement in the emergency setting as a life-saving treatment and a bridge solution to elective surgery.
{"title":"Emergency CTA Diagnosis and Successful Endovascular Management of Aorto-duodenal Fistula","authors":"G. Lassandro, Giorgio Mazzotta, S. Picchi, G. Sarti, F. Spinetti, A. Corvino, Giampaolo Santini, F. Tamburro","doi":"10.26676/jevtm.293","DOIUrl":"https://doi.org/10.26676/jevtm.293","url":null,"abstract":"Aorto-enteric fistula is defined as a communication between the aorta and the gastrointestinal tract. It is a rare but life-threatening condition associated with almost 100% mortality without prompt surgical intervention. The most common type of aorto-enteric fistula is the aorto-duodenal fistula. Upper gastrointestinal bleeding is the most common presentation, ranging from a minor haemorrhage to massive life-threatening bleeding.Computed tomography angiography is the first-line modality for imaging evaluation of suspected aorto-enteric fistula. Surgical treatment of this condition may be open aortic repair, in situ graft replacement if present, or placement of an extra-anatomical bypass.We present our case of a 71-year-old woman with infected aorto-aortic graft complicated by aorto-duodenal fistula. The patient was successfully treated by aortic Zenith Cook cuff endovascular placement in the emergency setting as a life-saving treatment and a bridge solution to elective surgery.","PeriodicalId":41233,"journal":{"name":"Journal of EndoVascular Resuscitation and Trauma Management","volume":" ","pages":""},"PeriodicalIF":0.4,"publicationDate":"2023-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49378777","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Johan Buitendag, Saffiya Variawa, Aashish Diayar, Pieter Snyders, Pieter Jacobus Rademan, Nabeel Allopi, David Thomas McGreevy, Tal Martin Hörer, George Oosthuizen, Boris Kessel
Background: Resuscitative endovascular balloon occlusion of the aorta (REBOA) is a temporary management modality for non-compressible torso haemorrhage that can be deployed in the pre- and intrahospital setting. This study aimed to compare outcomes following balloon placement in the three aortic zones.Methods: This is a retrospective study using data from the ABO Trauma Registry. Relevant entries from January 2014 to December 2019 were used and stratified into three groups: those who received Zone 1, 2, or 3 balloon placements.Results: The study sample consisted of 237 patients: 63 (27%) women and 174 (73%) men, median age 35 years. The primary location of the REBOA balloon was in Zone 1 for 180 patients, while it was nine in Zone 2 and 48 in Zone 3. Complication rates and total durations did not differ significantly between inflation zones. Emergency department mortality rates for Zones 1 and 2 patients were significantly higher than for Zone 3 (P = 0.04), but there was no difference between groups in 24-hour and 30-day mortality rates.Conclusions: REBOA is currently used in the emergency setting for temporary stabilisation of the bleeding patient. In this cohort, balloon placement occurred in all zones of the aorta for similar durations, with no difference in complication rates between zones. Inadvertent Zone 2 placement was not found to be associated with increased complication rates.
{"title":"Comparison of Outcomes Relating to REBOA Inflation Zones: Report from the ABO Trauma Registry","authors":"Johan Buitendag, Saffiya Variawa, Aashish Diayar, Pieter Snyders, Pieter Jacobus Rademan, Nabeel Allopi, David Thomas McGreevy, Tal Martin Hörer, George Oosthuizen, Boris Kessel","doi":"10.26676/jevtm.276","DOIUrl":"https://doi.org/10.26676/jevtm.276","url":null,"abstract":"Background: Resuscitative endovascular balloon occlusion of the aorta (REBOA) is a temporary management modality for non-compressible torso haemorrhage that can be deployed in the pre- and intrahospital setting. This study aimed to compare outcomes following balloon placement in the three aortic zones.Methods: This is a retrospective study using data from the ABO Trauma Registry. Relevant entries from January 2014 to December 2019 were used and stratified into three groups: those who received Zone 1, 2, or 3 balloon placements.Results: The study sample consisted of 237 patients: 63 (27%) women and 174 (73%) men, median age 35 years. The primary location of the REBOA balloon was in Zone 1 for 180 patients, while it was nine in Zone 2 and 48 in Zone 3. Complication rates and total durations did not differ significantly between inflation zones. Emergency department mortality rates for Zones 1 and 2 patients were significantly higher than for Zone 3 (P = 0.04), but there was no difference between groups in 24-hour and 30-day mortality rates.Conclusions: REBOA is currently used in the emergency setting for temporary stabilisation of the bleeding patient. In this cohort, balloon placement occurred in all zones of the aorta for similar durations, with no difference in complication rates between zones. Inadvertent Zone 2 placement was not found to be associated with increased complication rates.","PeriodicalId":41233,"journal":{"name":"Journal of EndoVascular Resuscitation and Trauma Management","volume":"19 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-06-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136353866","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
At times, when the endovascular delivery or catheter system is unstable, two wires can be used, forming a double wire system.
有时，当血管内递送或导管系统不稳定时，可以使用两根导线，形成双线系统。
{"title":"Using Double Wires as a Stability Solution","authors":"T. Hörer, D. McGreevy","doi":"10.26676/jevtm.291","DOIUrl":"https://doi.org/10.26676/jevtm.291","url":null,"abstract":"At times, when the endovascular delivery or catheter system is unstable, two wires can be used, forming a double wire system.","PeriodicalId":41233,"journal":{"name":"Journal of EndoVascular Resuscitation and Trauma Management","volume":" ","pages":""},"PeriodicalIF":0.4,"publicationDate":"2023-06-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47494502","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Puncture site or vascular access bleeding may be managed with open or endovascular methods. In this paper, we shortly describe alternative methods for endovascular and hybrid bleeding control.
{"title":"Alternative Methods for Endovascular and Hybrid Bleeding Control","authors":"T. Hörer, D. McGreevy","doi":"10.26676/jevtm.290","DOIUrl":"https://doi.org/10.26676/jevtm.290","url":null,"abstract":"Puncture site or vascular access bleeding may be managed with open or endovascular methods. In this paper, we shortly describe alternative methods for endovascular and hybrid bleeding control.","PeriodicalId":41233,"journal":{"name":"Journal of EndoVascular Resuscitation and Trauma Management","volume":" ","pages":""},"PeriodicalIF":0.4,"publicationDate":"2023-06-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46881802","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
京公网安备 11010802042870号
京ICP备2023020795号-1
扫码关注我们
求助内容：
应助结果提醒方式：