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目的：防治严重胸部开放性损伤引起气胸、血胸致呼吸困难，脏器或大血管损伤的大出血休克及术后并发症。方法对2012年1月至2013年1月，58例此类病人术前保持呼吸道通畅，快速扩容，心理护理；术中安全措施实施、操作技巧的应用；术后鼓励病人咳嗽、咳痰、深呼吸，有效拍背刺激咳嗽排痰，保持引流通畅，指导病人早期下床活动，预防感染及肺不张。结果有1例主动脉弓破裂伴严重失血性休克时间过长抢救无效死亡，其余病人安全度过了围手术期。结论早期诊断，抗休克，迅速做好必需的术前准备，赢得手术时机，尽早进行伤口的封闭，保持呼吸道通畅，术中安全措施的实施，操作技巧的应用，鼓励病人早期下床活动，合理营养，观察引流管及伤口的情况，术后抗生素的应用，是挽救病人的生命、防止并发症，促进病人康复的关键。“,”Objective Prevention and treatment of severe open pneumothorax,hemothorax caused the breath difficulty caused by injury of chest,organ or vascular injury after hemorrhage shock and postoperative complications.Methods From 2012 to January to 2013 January,58 cases of such patients to maintain airway patency,pre-operative rapid expansion,psychological nursing;application of safety measures during implementation ,operation skills;postoperative encourage patients to cough,expec-toration,deep breathing,effective back stimulus cough and expectoration,keep smooth drainage,guiding patients early ambulation,prevention of infection and atelectasis. Results There were 1 cases of aortic rupture with serious hemorrhagic shock time long rescue invalid death ,the other patient safety through peri operation period .Conclu-sion Early diagnosis,anti shock,quickly prepared necessary preoperative,win the operation time,early closure of the wound,to maintain airway patency,the implementa-tion of safety measures in operation,application skills,encourage patients to early ambulation,reasonable nutrition,observe drainage tube and the wound,postoperative ap-plication of antibiotics,is to save the patient's life,prevent the complications,and promote the rehabilitation of patients.