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目的探讨胸部闭合性损伤在ICU监护下的临床表现及处理后的病情转归。方法将116例胸部闭合性损伤患者分为两组,每组58例,一组进行常规ICU监护,二组加用有创监测,中心静脉压监测,进行对比分析。结果两组胸部闭合性损伤患者,一组常规ICU监护除胸部情况外,异常39例,占67.2%,而加用有创监测,中心静脉压监测的异常47例,占81.03%。92例患者病情稳定转出ICU监护病房,13例患者再次进行二期手术,死亡11例,占9.5%。结论胸部闭合性损伤多为合并伤,伤情危重、变化迅速,ICU监护可以及时发现病情变化,对临床治疗有决定性的意义。对较为危重及有危重倾向的患者加用有创的中心静脉压监测非常必要,能够更早的提供血液动力学的变化,尽早的发现病情的变化,能够得到积极的处理。
Objective To investigate the clinical manifestations of thoracic closed injury under the supervision of ICU and the outcome of the treatment. Methods One hundred and sixty-six patients with thoracic closed injury were divided into two groups, 58 patients in each group. One group received routine ICU monitoring. The other two groups received invasive monitoring and central venous pressure monitoring. Results In the two groups of patients with closed chest injury, a group of routine ICU monitoring except for the chest condition was abnormal in 39 cases (67.2%). However, 47 cases (81.03%) had abnormal monitoring with central venous pressure monitoring. 92 patients were transferred out of ICU intensive care unit in stable condition, and 13 patients underwent second phase operation again, with 11 deaths (9.5%). Conclusion Most of the closed chest injuries are combined injury. The injury is critical and rapidly changing. ICU monitoring can detect the change of the disease in time, which has a decisive significance for clinical treatment. It is necessary to use invasive CVC monitoring in the more critical and critically ill patients, to provide hemodynamic changes earlier, to find out the changes as soon as possible, and to be actively treated.