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1985年6月～2004年11月收治胸部创伤91例(开放损伤10例、闭合损伤81例),其中胸部软组织伤22例,单根肋骨骨折29例,多根肋骨骨折25例(浮动胸壁5例),气胸5例,血胸8例,血气胸11例,支气管挫裂伤4例,肺挫裂伤14例,合并腹部脏器损伤12例,合并其他部位损伤32例,创伤性窒息5例,并有创伤失血性休克21例,并ARDS5例。对症治疗39例,胸壁外固定30例,胸腔闭式引流术20例,开胸手术2例,其他合并伤手术22例,行呼吸机治疗4例,治愈89例,死亡2例。作者认为,应及时对危及生命的多根、多段肋骨骨折浮动胸壁和张力性血气胸患者作出早期诊断和及时处理。对于已行胸腔闭式引流术的伤员,观察中引流气体不见减少,应及时行床边纤维支气管镜检查,既能及时吸出气管、支气管内的痰液和血凝块,又能明确诊断气管、支气管挫裂伤。对于下胸部开放性损伤,应及时明确有无胸腹联合伤。积极手术处理腹部脏器损伤。
From June 1985 to November 2004, 91 cases of thoracic trauma were treated (open injury in 10 cases, closed injury in 81 cases), including 22 cases of soft tissue injury in the chest, 29 cases of single rib fracture, 25 cases of multiple rib fractures (floating chest wall 5 5 cases of pneumothorax, 8 cases of hemothorax, 11 cases of pneumothorax, 4 cases of bronchial contusion and laceration, 14 cases of lung contusion and laceration, 12 cases of abdominal organ injury combined with 32 cases of other parts of the injury, traumatic asphyxia 5 Cases, and traumatic hemorrhagic shock in 21 cases, and ARDS5 cases. Symptomatic treatment in 39 cases, chest wall fixation in 30 cases, thoracic drainage in 20 cases, thoracotomy in 2 cases, 22 cases of other combined injuries, ventilator treatment in 4 cases, 89 cases were cured, 2 died. The authors believe that timely diagnosis and timely treatment of endangering life of multiple, multi-rib fractured floating chest wall and tension pneumothorax patients. For those who have undergone closed thoracic drainage, there is no reduction in the drainage of gas in the observation. They should be examined by bedside fiberoptic bronchoscopy in time. Both the tracheal and bronchial sputum and blood clots can be promptly aspirated and the trachea, Bronchial contusion. For the open chest injury, should be promptly clear whether the joint thoracoabdominal injury. Positive surgical treatment of abdominal organ injury.