胸部刀刃穿透伤112例临床分析

Clinical diagnosis and treatment of 112 patients with punctured thorax injury

目的 总结胸部刀刃穿透伤临床特点、诊断及处理的临床经验。方法 对 1995～ 1999年我科收治的 112例胸部刀刃穿透伤临床诊治情况进行分析。结果 早期明确诊断 10 9例 ,漏诊 3例。闭式引流98例、胸穿 19例 ,手术治疗 5 2例 ,其中开胸 2 7例、开腹 2 5例。治愈 10 5例 ,死亡 5例。结论 (1)胸部刀刃穿透伤合并伤多、伤情重、变化快、休克发生率高 ;(2 )迟发性血气胸、膈肌破裂、腰背部伤早期易漏诊 ;(3)刀刃所致的胸腹联合伤 ,漏诊或手术处理不当易发生胸腔感染 ;(4)手术率高 。

Objective To describe and sum up the clinical features and clinical experience in diagnosis and treatment of punctured thorax.?Methods The clinical data of 112 cases of breast punctured wound treated in our hospital in 1995-1999 were analysed.?Results Among 112 cases,there were 109 cases receiving definite early diagnosis and 3 cases of misdiagnosis.Ninety eight cases had closed drainage,and 52 cases had operations(27 thoracotomy,25 laparotomy).One hundred and five cases were cured and 5 cases died.?Conclusions (1)?The punctured thorax injury is often complicated by some other severe wounds and high rate of shock.(2)?Tardive pyothorax,ruptured diaphragm and wound in the loin and back are likely to get missed diagnosis.(3)?Infection in thoracic cavity is a probable complication of thoraco abdominal injury with missed diagnosis or improper handling in operation.(4)?Operation is a preferential treatment and early treatment may get desired results.