重症胸部创伤的救治与监护

Treatment and care of severe chest trauma

目的探讨研究救治和监护重症胸部创伤患者的具体方法。方法选取于2012年1月—2013年9月我院收治的重症胸部创伤患者60例,给与急诊手术救治方法,给患者解除呼吸道阻塞,维持改善患者呼吸功能,使用机械呼气,进行胸腔穿刺、胸腔闭式引流,开胸手术等治疗。对合并伤展开积极处理,为患者充分止痛,开通患者静脉通道进行液体复苏,并展开严密观察期病情变化的监护措施。结果采用急诊手术救治方法并对其展开了严密观察期病情变化的监护措施下的重症胸部创伤患者治愈55例,治愈率为91.7%,死亡5例,死亡率为8.3%,但其治疗表现也有一定积极意义。结论重症胸部创伤患者通常易伴随创伤性休克,急诊手术能在短时间内做到有效抢救,但时间短,对于术前准备的充分和抢救的准确性与及时性要求很高,需要医生既有较强的鉴别诊断能力和熟练的抢救技术,高度的责任心,护士护理过程的严谨负责,只要掌握了正确的手术时机,做好了充分的准备工作,就能有效的降低死亡率,获得满意的治疗效果,为患者挽救一次生机。

Objective To explore the specific methods of treatment and monitoring of severe chest trauma patients. Methods 60 patients with severe thoracic trauma were selected in 2012 January to 2013 September in our hospital were given to the patients, emergency operation treatment, to relieve airway obstruction, maintain improve the respiratory function, the use of mechanical breath, chest puncture, closed thoracic drainage, thoracic operation treatment. Active treatment of associated injury, pain for pa- tients with full, open venous channel in fluid resuscitation, monitoring measures and strict observation of disease changes. Results Severe thoracic trauma patients with emergency operation treatment method of monitoring measures and carried out strict observa- tion of disease changes on the next 55 cases were cured, the cure rate was 91.7%, 5 cases died, the mortality rate was 8.3%, but the treatment performance also has certain positive significance. Conclusion The patients with severe chest trauma is usually as- sociated with traumatic shock, emergency rescue operation can be done effectively in a short time, but time is short, the accuracy and timeliness of preoperative preparation for full and rescue is very high, need a doctor has differential diagnosis ability and skilled rescue techniques, high sense of responsibility, care the process of nurses responsible, as long as the master of the timing of operation right, ready to work, can effectively reduce the mortality rate, obtain satisfactory curative effect, for patients to save a life.