1270例闭合性胸部损伤患者的临床分析

Clinical analysis of 1270 patients with blunt chest injury

目的总结闭合性胸部损伤的诊治体会。方法回顾性分析1270例闭合性胸部损伤的受伤类型及治疗结果。结果1270例中治愈1232例,死亡38例,其中失血性休克20例,多脏器功能衰竭(MOF)7例,成人呼吸窘迫症5例,延迟性假性胸主动脉瘤破裂1例,呼吸道窒息2例,张力性气胸2例,急性心包填塞1例。结论闭合性胸部损伤,损伤机制复杂,临床表现复杂,常伴严重多发伤。重视院前急救,重视胸部合并其他部位的多发伤,及时准确判断生命体征,尽快采取有效急救措施维持呼吸、循环功能,及时胸腔闭式引流,必要时开胸探查等,是救治成功的关键。

Objective To summary the experience of the diagnosis and treatment of blunt chest injury. Methods 1270 cases with blunt chest injury were retrospectively analyzed. Results There were 1232 cases cured. 38 cases were dead including 20 cases with hemorrhagic shock, 7 eases with multiple organ failure, 5 cases with adult respiratory distress syndrome, 1 case with delayed rupture of pseudo--thoracic aortic aneurysm-o, 2c cases with tension pneumothorax and 1 case with acute cardiac tamponade. Conclusions The clinical manifestations and mechanism of blunt chest injury are complex, which is often accompany with severe multiple trauma. It is very important to treat blunt chest injury with pre-hospital first aid, effective measures to maintain respiration, circulation, promptly closed thoracic drainage and ex- ploratory thoracotomy.