严重胸部外伤的手术救治

Operational therapy of severe thoracic injury

目的 :初步探讨严重胸部外伤的诊断、失血性休克复苏、急诊手术的基本原则和临床救治经验。方法 :在急诊科及时缝合关闭开放的胸部创口 ,床边行胸腔闭式引流术 ,如病情允许 ,则行胸片、超声检查 ,尽可能纠正失血性休克 ,及时行急诊手术。结果 :在边诊断、边抢救、及时大量输血的前提下 ,迅速急诊手术。全组存活 2 7例 ,死亡 8例。结论 :严重胸部外伤病情凶险危急 ,急诊手术的决策一定要果断。

Objective:To discuss the basic principles and the clinical therapy experiences in the diagnose of severe thoracic injury,resuscitation of hemorrhage shock and emergency operation.Method:Open thoracic traumas were closed in time in the emergency room,and the closed thoracic drainage was performed at bedside.If patients' conditions allowed,chest film and ultrasonic examination should be performed.Hemorrhagic shock should be corrected and emergency operation should be performed as possible.Result:While a patient was receiving a larger amount of blood transfusion,the diagnosis and the first aid should be performed at the same time.The emergency operation should be performed rapidly.There were 8 patients died and 27 survived in the series. Conclusion:The distinctive feature of this kind operation is both dangerous and urgent.The decision of the emergency operation must be resolute.