急性胸部创伤217例治疗体会  

SURGICAL TREATMENT OF 217 CASES OF ACUTE THORACIC INJURIES

作　　者：周宝庆[1] 张朝满[1] 张旭[1] 辛国华[1] 李敬连[1] 张玉琛 

机构地区：[1]承德医学院附属医院胸外科

出　　处：《承德医学院学报》1991年第2期88-91,共4页Journal of Chengde Medical University

摘　　要：本文介绍217例胸部外伤的治疗经验。其中严重胸部损伤54例,死亡7例。总死亡率为3.22％。本组217例中,闭合性胸外伤163例,开放性胸外伤54例。按伤情分类:低血容量性休克18例,张力性气胸6例,反常呼吸15例,创伤性膈疝5例。本文讨论重症胸外伤的抢救经验,强调疑有胸、腹内脏损伤要及时手术,及时解除胸内压迫和维持正常呼吸功能的重要性。手术29例,均成功。非手术死亡7例,有4例是反常呼吸,2例合并腹腔空腔脏器损伤,死于中毒性休克。另1例死于外伤性湿肺继发感染。The artical in troduces experience in treatment oi 217 cases of thoracic injuries, including 54 badly jnjuried patients.Seven patients died, giving a total mortality rate of 3.22％, Of the 217 patients, 163 suffering from closed thoracic trauma, 54 open thoracic trauma. In accordance with the conditions of various wounds, 18 cases belonged to hypovolemic shock,6 to tension pneumo thorax, 15 to paradoxical respiration, and 5 to traumatic diaphragmatic hernia The discussion in this article was focused on the rescue experience of severe thoracic trauma. The authors consider the stress should be laid on the operative treatment which must be given as promptly as possible when the physician suspected the injuries to be intrathoraeic and intraabdomial visceral; the first priority of management should be to provide an airway and restore circulation and intrathoracic constriction must be eliminated immediately so as to keep the respiartory and circulative function narmal.The operation performed on 29 patients all was completely successful.Seven patients treated with nonoperative therapy died, of whom 4 patients died of paradoxical respiration, 2died of toxic shock caused by combined injuries of the abdominal and hollow organs and 1 died of secondary infection following tJaumatic wetlung.

关 键 词：胸部外伤 反常呼吸 肋骨骨折 血气胸 胸壁软化 

分 类 号：R[医药卫生]