142例老年人胸外伤的临床分析

Clinical analysis of senile chest trauma：a report of 142 cases

目的分析老年胸外伤的临床特点、治疗及预后。方法把6种不同受伤形式的142例老年胸外伤患者分为两组进行治疗，对46例进行了无创治疗，对96例进行了有创治疗。结果死亡11例，其中6例死于失血性休克（严重胸部创伤及胸部损伤以外损伤如肝、脾破裂），5例死于创伤后肺部感染。结论创伤后出现失血性休克的老年患者死亡率显著增加；创伤前有呼吸道疾患者，伤后出现肺部并发症的可能性大大增加。迟发性血胸发生与否和所受创伤性质有关，而与年龄无密切关系。老年人胸外伤的早期死亡原因是失血性休克，后期死亡原因是肺部感染。

Objective To analyze the clinical features, treatment and prognosis of senile patients with chest trauma. Methods 142 cases of senile patients with chest trauma were divided into two groups according to six different forms of injuries, 46 cases got noninvasive treatment, while 96 cases got invasive treatment. Results Eleven cases died, in which six cases died of hemorrhagic shock caused by severe chest injury and extrathoracic injuries such as hepatic rupture or splenic rupture, and five eas- es died of puhmonary infection after injury. Conclusion The mortality of senile patients with the occurrence of hemorrhagic shock after injury increases significantly; with respiratory disease before injury, the possibility of occurrence of pulmonary complications af- ter injury increases consunedly . Whether the tardive hemathorax happen or not happen is related to the property of trauma, and has no affinity with age.The early cause of death of senile patients with chest trauma is hemorrhagic shock,and late one is pulmonary infection.