创伤性血胸观察治疗失败的危险因素分析

Risk factors of failed observational treatment of traumatic hemothorax

目的分析探讨创伤性血胸观察治疗失败的危险因素。方法收集2012年1月至2018年12月期间胸腔外科收治的54例次行观察治疗的创伤性血胸患者临床资料,分析其治疗效果。通过多因素分析观察治疗失败的危险因素。结果观察治疗总失败率为59.26%(32/54)。观察治疗失败组在血胸量、住院时间、合并气胸、大于3根肋骨骨折患者比例等方面均明显高于治疗成功组(P<0.05)。观察治疗失败的独立危险因素是合并气胸(OR=9.529,95%CI:1.988~45.580,P=0.005)和肋骨骨折大于3根(OR=5.535,95%CI:1.065~28.754,P=0.042)。结论合并气胸和肋骨骨折大于3根是创伤性血胸观察治疗失败的危险因素,应将合并气胸和肋骨骨折情况纳入创伤性血胸的观察治疗决策中。

Objective To identify the risk factors of failed observational treatment of traumatic hemothorax.Methods Clinical data of traumatic hemothorax combined with observational treatment were selected from the data of chest trauma cases admitted to the thoracic surgery department from January 2012 to December 2018.The treatment effect was analyzed,and the risk factors of failed observational treatment were analyzed by multivariate analysis.Results The total failure rate of observational treatment was 59.26%(32/54),and the details of hemothorax volume,length of stay in hospital,pneumothorax and patients with more than 3 rib fractures in the failed conservative treatment group were more than those in the successful treatment group(P<0.05).Independent risk factors of failed observational treatment were more than 3 rib fractures(OR=5.535,95%CI:1.065-28.754,P=0.042)and pneumothorax(OR=9.529,95%CI:1.988-45.580,P=0.005).Conclusion Pneumothorax and more than 3 rib fractures are the independent risk factors of failed observational treatment,and should be included in the observational treatment decision of traumatic hemothorax.