502例下胸部锐器贯穿伤的治疗  

Treatments in patients with penetrating injuries of the lower chest a review of 502 cases

作　　者：程邦昌[1] 涂仲凡[1] 毛志福[1] 林道明[1] 高尚志[1] 

机构地区：[1]湖北医科大学附属第一医院,武汉430060

出　　处：《急诊医学》2000年第5期302-304,共3页

摘　　要：目的 :探讨下胸部锐器、枪弹、火器贯穿伤的治疗经验。方法 :回顾分析 5 0 2例下胸部锐器贯穿伤的临床资料及治疗措施。结果 :全组治愈率 83 87% ,病死率 4 2 3 %。结论 :抢救此类病例宜静吸复合全麻插气管双腔插管 ,作剖胸或胸腹联合切口径路 ,先处理致命性损伤。对合并全身多发严重创伤病例 ,提倡控制损伤 。Objective:Retrospective analysis of emergency treatment of patients with penetrating injuries of the lower chest during the past 20 years.Methods:Total 502 cases:male 441,female 61.The age ranged from 2 to 80 years old.Single injury 212 cases,multiple injuries 145 cases,with whole body multiple organs injuries 145 cases.One organ injuried 239 cases,2 Organs injuried 106 cases,3～6 organs injuried 157 cases;associated with shock 332 cases (66 13%).All the patients received surgical treatment by thoracotomy or thoracolaparotomy incision ligature of ruptured vessels or reconstructive repair,repair of lung,diaphragm,heart,bowel,liver,spleen,repair of rupture esophagus,lobectomy of lung,thoracoplasty etc.Results:327 patients received one surgical treatment,142 patients received 2 operations and 3 to 5 operations in 27 cases.The cure rate in the group was 83 87%,mortality rate 4 23%.Couclusion:Prognostic factors for these injuries included caues of injury,time taken to get to hospital,resuscitation measures,and the resources of the hospital.It is recommended to first coutrol the life threatening injuries and to do a few staged operations to these severe multitrauma patients

关 键 词：下胸部锐器伤 多发伤 救治 并发症 

分 类 号：R82[医药卫生—临床医学]