肋骨骨折与肺挫伤

Fractures of the Rib and Pulmonary Contusion

本文总结48例肋骨骨折合并肺挫伤。其中43例为多根多处肋骨骨折伴肺挫伤:5例为单处骨折伴肺挫伤。临床资料表明多根多处肋骨骨折(连枷胸)的伤员之呼吸窘迫症状并不经常和肋骨骨折数目成正比。连枷胸所见的呼吸窘迫,低氧血症及肺内分流增加,主要是肺挫伤导致的肺实质性损害引起,而非胸壁反常运动造成。早期充分的止痛是有效的治疗方法。

A retrospective analysis of 48 eases of rib fractures with pulmonary contusion was presented, Among them, 43 patients suffered from flail chest injury and other 5 patients had rib fractures accompanied with pulmonary contusion. The clinical findings Suggested that the respiratory distress seen with flail chest was not always directly proportional to the number of rib fracture. The respiratory distress, hypoxemia and incrcased intrapulmonary shunt were primarily due to pulmonary parenchymal insult resulting from contusion and were not caused by paradoxical motion of the chest wall. The most effective treatment is the adequate pain relief at the early stage （such as cpidural anesthesia or intercostal nerve blocks）.