创伤性血气胸692例诊治分析  

Clinic diagnosis and therapy of trauma hemopneumothorax： A report of 692 cases

作　　者：郭清奎[1] 吕志前[1] 詹晓洪[2] 项信青[2] 楼伟华[2] 

机构地区：[1]上海交通大学附属上海市第六人民医院胸心外科,200233 [2]浙江省义乌市中心医院胸心外科

出　　处：《临床外科杂志》2010年第7期466-468,共3页Journal of Clinical Surgery

摘　　要：目的 总结创伤性血气胸及其合并伤的临床诊断及治疗经验,以提高对该疾病的认识.方法 回顾性分析1980年3月至2009年4月我科收治692例创伤性血气胸患者的临床资料,根据不同的诊治方案,包括保守观察、单纯胸腔穿刺、闭式胸腔引流、剖胸手术、呼吸功能竭衰者应用呼吸机及多发伤请相关科室协助诊治等,评价各自的疗效.对创伤性血气胸导致死亡危险因素进行单因素和多因素相关分析.结果 本组治愈635例,治愈率为91.8%,死亡57例,死亡率为8.2%.单因素分析创伤性血气胸死亡的危险因素主要为休克（OR=1.068,95%CI：1.032～1.125,P=0.001）和合并多发伤（OR=0.682,95%CI：0.128～0.735,P=0.007）.多因素分析创伤性血气胸死亡的危险因素为休克（OR=1.052,95%CI：1.002～1.105,P=0.031）.结论 休克和合并多发伤是创伤性血气胸导致死亡的独立危险因素.Objective To summarize the experience of clinical diagnosis and therapy on trauma hemopneumothorax. Methods The clinical data of 692 patients with trauma hemopneumothorax who were admitted in our department from March 1980 to April 2009 were reviewed and analyzed. The pa- tients were given different treatments including conservative observation, simple thoracic cavity puncture, closed chest drainage, exploratory thoraeotomy, and use of respiratory ventilator in respiratory failure patients, and treatment of multiple organ injuries with the aid of other relevant departments and so on. Depending on the different diagnosis and treatments, the efficacy was evaluated and risk factors contributing to deaths were examined by single - factor and multi - factor correlation analyses. Results A total of 635 cases were cured with the cure rate being 91.8% and 57 patients died with the fatality rate of 8.2%. The single - factor correlation analysis revealed that shock （ P = 0. 001 ） and multiple injuries （ P = 0. 007） were the main factors for death. Furthermore, shock was also considered to be a risk factor for death by multi -factor analysis （P = 0. 031, OR = l. 052,95% CI：1. 002 - 1. 105 ）. Conclusion Shock and multiple injuries are the main independent risk factors for trauma hemopneumothorax.

关 键 词：创伤 血气胸 多发伤 危险因素 

分 类 号：R655[医药卫生—外科学]