肋骨骨折数量区域与胸腹腔器官损伤的关系  

Relation of rib fracture number or distribution and organ injury of chest and abdominal cavity

作　　者：熊健[1] 许咏冬[1] 吴蕾[2] 王长涛[1] 李智成[1] 王冬冬[1] 

机构地区：[1]上海市浦东医院复旦大学附属浦东医院筹胸外科,上海201300 [2]上海市浦东医院复旦大学附属浦东医院肿瘤科,上海201300

出　　处：《中国急救医学》2014年第3期227-229,共3页Chinese Journal of Critical Care Medicine

基　　金：上海市浦东新区卫生系统学科带头人培养计划资助项目（PWRd2012-2）

摘　　要：目的通过分析胸外伤后肋骨骨折与胸腹腔组织器官损伤的关系，提高胸腹联合伤的诊断救治率。方法回顾性分析我科收治的317例胸部创伤致肋骨骨折患者，对其创伤原因、骨折分布区域、骨折根数、创伤严重程度评分（ISS评分）、联合腹腔及胸腔组织器官损伤数量进行分析。结果除肺挫伤外，上胸部骨折多并发气管损伤，中胸部膈肌损伤发生率最高，而下胸部腹腔脏器损伤发生率最高，3组比较差异有统计学意义。肋骨骨折根数越多，合并胸腹部组织器官损伤发生率越高，但差异无统计学意义。结论肋骨骨折数量及区域与相关胸腹腔组织器官损伤密切相关，对不同区域和数量的肋骨骨折，要高度警惕胸腹腔器官的损伤，以防漏诊漏治。Objective To improve the diagnostic accuracy of thoracoabdominal injuries by analyzing the relation of rib fracture and the organ injury of chest and abdominal cavity. Methods 317 cases of rib fracture in our department were retrospectively analyze by their traumatic factors, distribution and number of rib fracture, ISS score and the injured organ number of chest and abdominal cavity. Results In spite of pulmonary contusion, rib fracture in upper breast was more complicating with trachea injury than in middle breast and pectus. The septum injury number was increased when rib fracture occurred in middle chest, while the injury of abdominal organ was more often in the patients with fracture of inferior thoracic ribs. All of which had statistical differences. The rate of thoracoabdominal injury raised when the rib fracture number increased but without statistical difference. Conclusion The number and distribution of rib fracture has a close relation with organ injury of chest and abdominal cavity. To prevent missed diagnosis of organ injury, we should put more attention to the rib fractures, especially for the fractures＇ number and location.

关 键 词：肋骨骨折 器官 创伤严重程度评分(ISS) 

分 类 号：R971.2[医药卫生—药品]