以张力性气胸为主的严重多发伤急诊救治

目的：探讨以张力性气胸为主的严重多发伤的急诊救治。方法对46例以张力性气胸为主的严重多发伤患者的急诊救治进行回顾性分析。结果41例经急诊救治和病区综合治疗康复出院，其余5例患者由于存在严重颅脑损伤、腹腔脏器损伤及骨盆骨折导致多脏器功能衰竭，抢救无效死亡。结论床边B超结合诊断性的胸腔穿刺在张力性气胸的诊断上安全、省时；应用“腹腔镜穿刺鞘卡”穿刺置管行胸腔闭式引流术也因其操作简单、安全、快速、有效在治疗上取得满意的效果。

Objective To explore the emergency treatment of severe multiple trauma complicated mainly tension pneumothorax. Methods 46 patients with severe multiple trauma dominated by tension pneumothorax were retrospectively analyzed. Results 41 cases after emergency treatment and comprehensive treatment recovered and released from hospital, 5 cases because of severe craniocerebral injury, abdominal visceral injury and pelvic fractures led to multiple organ function failure and were rescued invalid and died. Conclusion The ultrasound combined with diagnostic pleural puncture in diagnosis of tension pneumothorax is a safety, time saving;The use of laparoscopic trocar for rapidly closed thoracic drainage in the treatment of tension pneumothorax is simple,easy,conv enient,effective and reliable, with satisfactory clinical outcomes.