紧急剖胸术在胸部创伤救治中的应用  

作　　者：祁彦君[1] 马连君[1] 郑梦利[1] 刘慧峰[1] 赵亚超[1] 

机构地区：[1]北京解放军第309医院胸外科,北京100091

出　　处：《湖南中医药大学学报》2016年第A01期185-186,共2页Journal of Hunan University of Chinese Medicine

摘　　要：目的探讨采用紧急剖胸术在胸部创伤救治中的应用.方法本次研究采用回顾性分析方法进行分析,选取 2010 年4 月 -2015 年4 月期间我院救治的 42 例胸部创伤患者的临床资料为本次的研究对象,对患者的临床资料进行整理分析,了解紧急剖胸术在胸部创伤救治中的应用. 结果在本次研究的42例患者中,所有患者的损伤严重度的评分在11分-64分之间,平均分数为32.56分,42例患者中有27例患者为穿透损伤,还有15例患者为钝性损伤.有30例患者入院时处于休克状态,占71.43%,失血量在1000ml-3500ml之间,平均出血量为2100ml;其中有24例患者的失血量在2500ml 以上.进入急诊室采用紧急剖胸术进行抢救的患者有8 例,在手术室进行紧急剖胸术的患者有 34例.所有患者入院到进行手术的时间均不超过半个小时.本次研究的42例患者中有15例患者死亡（35.71%）,死亡患者入院损伤严重度评分在51.3左右,导致患者死亡的主要原因是心脏压塞以及失血性休克.存活的27例患者中,21例患者属于穿透伤,6例患者属于钝性伤,存活的患者中有10例患者出现并发症.结论胸部创伤严重的患者可能会出现大出血、心脏压塞以及通气障碍,出现这些症状的患者应采用紧急剖胸术进行抢救,胸部高危部位穿透伤的患者要及时进行剖胸探查,提高患者的存活率.objectiveto explore the emergency cut open chest surgery in the application of chest trauma care. Methodsretrospective analysis method is used to carry on the analysis, this study selected in April 2010 - April 2015 to our hospital treatment during the period of the clinical data of 42 patients with chest trauma as the research object, the analysis of the clinical data of patients about emergency cut open chest surgery in the application of chest trauma care. Resultsin the study of 42 cases of patients, all patients with injury severity score between 11-64, an average score of 32.56 points, 27 patients with 42 patients were penetrating injury, and 15 patients with blunt injuries. With 30 patients admitted to hospital in a state of shock, accounted for 71.43%, blood loss between the 1000 ml to 3500 ml, average blood loss was 2100 ml; There are 24 patients blood loss in more than 2500 ml. Into the emergency room using emergency cut open chest surgery to rescue patients in 8 cases, in the operating room for emergency caesarean section in 34 cases of thoracic surgery patients. All patients admitted to hospital to undergo surgery for no more than half an hour. The study of 42 cases with 15 cases of patients died （35.71%）, death was hospitalized patients with injury severity score at about 51.3, is the leading cause of death in patients with cardiac tamponade and uncontrolled hemorrhagic shock. Survival of the 27 patients, 21 patients belong to the penetrating injury, 6 cases belong to blunt injury patients, survival in patients with 10 patients had complications. Conclusionthe chest trauma patients with severe bleeding may arise, cardiac tamponade and ventilation disorder, patients with these symptoms should adopt emergency cut open chest surgery for rescue, the chest high-risk area penetrating injury patients to timely are partitioned thoracic exploration, improve survival rates.

关 键 词：紧急剖胸术 胸部创伤 应用 

分 类 号：R197.3[医药卫生—卫生事业管理]