胸部创伤1080例临床分析

Clinical analysis of 1080 cases of thoracic traumas

目的 总结胸部损伤的发生原因及治疗经验。方法 回顾近 15年收治的 10 80例胸部损伤患者 ,肋骨骨折采用胸带包扎固定 ,闭合性血气胸倾向保守治疗 ,其中胸穿 85例 ,胸腔闭式引流 10 5例 ;开放性胸外伤主张积极剖胸手术 ,急诊手术 96例 ,合并伤以挽救生命为主。结果 全组治愈 10 6 7例 ,治愈率 98.8% ,死亡 13例 ,病死率1.2 % (死于浮动胸壁 5例 ,锐器伤致开放性血气胸失血性休克 3例 ,多系统损伤致多脏器衰竭死亡 5例 ) ,本组心血管外伤 7例 ,经急诊手术全部治愈。结论 交通事故为首位致伤原因 ,肋骨骨折是最常见的胸外伤 ,胸带包扎固定对稳定胸廓 ,减轻胸痛效果肯定 ,非手术是闭合性胸部损伤的主要治疗手段 ,剖胸手术是开放性胸外伤的最佳治疗方法。

Objective To summarize the causes leading to thoracic trauma and the corresponding treatments by analyzing 1 080 cases within the recent fifteen years. Methods\ Rib fracture was treated in a belt fixation way.Conservation treatment was preferable in treating closed pneumothorax and hemothorax.Among the 1 080 cases, 85 cases of thoracentesis and 105 cases of closed pleural cavity drainage.Operations were carried out for 96 cases. In treating combined injury,life saving was essential.Results\ 1 067 cases were cured at a rate of 98.8%.Thirteen cases died,the death rate being 1.2%(Among whom, five cases died of floating chest,three cases died of bemondagic shock caused by open pneumothorax and hemothorax resulting from sharp tools, and five cases died of MOSF due to multi organ injury).In addition,eight cases of candiovasular injury were all cured through emergency treatment.Conclusion\ Traffic accident can be regarded as the main cause leading to injury.Rib fracture frequently results in thoracic trauma.Belt fixation is helpful to fix chest and relieve pain.Non operation should be adopted as the main treatment of closed thoracic traumas while operation is the best in treating open thoracic traumas.