胸外伤伴多发伤245例临床诊治

Clinical diagnosis and treatment of thoracic injury in patients with multiple traumas

目的:探讨胸外伤伴多发伤临床诊疗特点。方法:回顾分析245例胸外伤伴多发伤临床诊治结果,合并颅脑外伤62例,腹部损伤63例,骨盆四肢损伤88例,两个以上部位损伤32例。损伤严重程度评分(14.54±5.35)分。结果:急诊剖胸手术21例,合并损伤手术132例。全组存活222例,病死23例,病死率9.39%。结论:胸外伤伴多发伤患者各部位伤在病理生理及诊治上相互影响很大,临床在重点治疗胸部损伤的同时,要注重及时处理合并损伤。

Objective：To investigate the characteristics of thoracic injuries with multiple traumas. Methods：A retrospective study was carried out in 245 patients with thoracic injuries combined with multiple traumas from October 2000 to October 2005. Total 245 patients were included this study, wherein 62 patients with brain injury, 63 patients with abdominal injury, 88 patients with pelvic and limbs injury and 32 patients with more than two parts of injuries. The average injury severity score（ISS） was 14.54 ± 5.35. Results：Twentyone patients underwent emergency thoracotomy while 132 patients underwent operation for multiple traumas. In the group,222 patients （90.61%） survived and 23 patients died with the mortality at 9.39%. Conclusions： Patients with thoracic injuries with multiple traumas are more severe. The pathogenesis of each injured part may interfere with clinical practice. Treatment should be concentrated on thoracic injury as well as associated traumas.