1167例胸外伤及合并伤的诊断和治疗

Chest trauma and associated injury:diagnosis and treatment of 1 167 cases

目的分析胸外伤的临床诊疗方法。方法回顾性分析1999年1月~2008年12月收治的1167例胸外伤患者临床资料,闭合性胸外伤1019例,开放性胸外伤148例;其中合并肋骨骨折819例,合并血气胸312例,合并其他部位复合损伤692例。结果本组治疗采用非手术治疗1112例,开胸手术治疗57例,住院期间死亡22例。结论胸外伤患者大多数经非手术治疗或是做简单的胸腔闭式引流术均可治愈,对较重胸外伤应准确掌握有无开胸指征,充分估计胸外伤患者的伤情,尽早手术,保护各脏器功能,机械通气等是抢救成功的重要措施。

Aim To summerise the diagnosis and treatment of chest trauma. Method The clinical data of I 167 cases of chest trauma, from Jan 1999 to Dec 2008 ,were retrospectively reviewed. 1 019 cases were closed chest trauma, 148 open chest trauma,819 cases associated with rib fracture,312 complicated with Hemopneumothorax,692 cases complicated with other position injuries. Result 1 112 cases were treated with non-operative method,57 cases operated,22 caes dead in hospital. Conclusion The majorities of chest trauma patients could be cured by non-operative method or simple thoracic close drainage. Chest opening operation indication for serious chest trauma should be carefully evaluated, and traumatic condition should be sufficiently studied, when the decision of operation was made. Operation should be performed as soon as possible to protect multiple organ function. Mechanical ventilation was an important measure for successful salvage.