急诊手术内固定对创伤性连枷胸患者短期血流动力学的影响  

Effect of Emergency Surgical Internal Fixation on Short-term Hemodynamics of Patients with Traumatic Flail Chest

作　　者：滕继平[1] 倪达[1] 程佑爽[1] 程云阁[1] 潘荣华[1] 朱智军[1] 

机构地区：[1]上海交通大学医学院附属第三人民医院胸心外科,上海交通大学医学院创伤研究所,上海201900

出　　处：《医学临床研究》2010年第12期2196-2198,共3页Journal of Clinical Research

基　　金：上海教委优秀青年教师科研专项基金（jdy09068）

摘　　要：【目的】研究急诊手术内固定治疗对创伤性连枷胸患者的血流动力学影响。【方法】本科2005年1月至2010年10月收治的70例胸外伤为主的创伤性连枷胸患者分为急诊手术组（n=34）与非手术组（n=36），记录伤情进行创伤评分；监测并记录24h内血流动力学指标包括心排量（CO）、肺毛细血管楔压（PCWP）、平均动脉压（MAP）、中心静脉压（CVP）、心率（HR），并进行统计学分析和比较。【结果】手术组患者的HR、CVP较术前明显下降（P〈0．05），CO、PCWP、MAP明显增加（P〈0．05），入院24h的血流动力学指标手术组显著优于非手术组（P〈0．05）。【结论】急诊手术内固定治疗能改善创伤性连枷胸患者的短期血流动力学指标，具有一定的近期疗效。[Objective]To investigate the impact of emergency surgical internal fixation on the hemodynamics of patients with traumatic flail chest. [Methods]A total of 70 traumatic flail chest patients in our unit from Jan. 2005 to Oct. 2010 were divided into surgical group（ n =34） and non-surgical group（ n =36）. The record for traumatic condition was assessed with AIS-ISS. The hemodynamic parameters in 24 hours including cardiac output（CO）, pulmonary capillary wedge pressure （PCWP）, mean arterial pressure （MAP）, central venous pressure（CVP） and heart rate（HR） were measured, statistically analyzed and compared. [Results]In surgical group after operation, HR and CVP decreased significantly（ P 〈0.05） , while CO, PCWP and MAP increased obviously（ P 〈0.05）. The hemodynamic parameters in surgical group were significantly better than those in non surgical group 24 hours after admission（ P 〈0.05）. [Conclusion]The emergency surgical internal fixation can improve the short-term hemodynamic parameters of patients with traumatic flail chest, and has the shortterm efficacy.

关 键 词：连枷胸/外科学 血液动力学 

分 类 号：R655[医药卫生—外科学]