73例严重胸部创伤救治体会

The experiences in rescue of 73 patients with serious chest injuries

目的 分析 3年来我院收治的严重胸部创伤病例特点 ,围绕其院内死亡原因 ,总结成功救治的经验及体会。方法 根据 73例严重胸部伤构成比及住院病死率之间的关系 ,对伤后常见的致死原因 ,如失血性休克、成人呼吸窘迫综合征 (ARDS)和多系统器官衰竭 (MSOF)等进行分析。结果 全组生存 6 3例 ,死亡 10例 ,住院病死率 13.6 %。住院早期死亡原因以失血性休克为主 ,晚期死亡原因多为ARDS和MSOF。结论 对于严重胸部创伤 ,急诊救治的时限具有重要意义。应针对胸部外特点 ,围绕严重胸外伤常见的致死原因 ,进一步改进急救及后续处理 。

Objective To analyse the characteristic of serious chest injuries in patients admitted to our hospital in the past three years and to summarize our rescuing experiences. Methods The relationship between the severe chest injuries and the mortality during hospitalization were analysed, including hemorrhagic shock, adult respiratory distress syndrome (ARDS) and multiple organ failure (MOSF).Results 63 cases survived and 10 died. The hospitalized mortality was 13.6%. Early death was mainly caused by hemorrhagic shock while the later deaths were by ARDS and MOF.Conclusion Early emergency treatment is essencial for severe chest injury. In view of the chest injuries and common causes of death in recent decades, it is important to improve the emergency treatment and subsequent management so as to reduce further the mortality rate.