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目的探讨县级医疗机构CT扫描检查对严重胸部创伤的价值。方法使用机型为GEHispeed dual的双层螺旋CT,对我院严重胸部创伤患者16例用胸部螺旋CT以10 mm层厚及间隔进行扫描,部分病灶采用后重建(拆薄)方法,进行观察分析影像。结果 16例严重胸部创伤病例,其中肺挫伤10例,肺撕裂伤2例,支气管断裂伤1例,肺不张2例,肺萎陷10例,血气胸8例,单纯气胸3例,血胸5例;发生肋骨骨折16例,双侧锁骨骨折2例,单侧锁骨骨折3例,第3、4胸椎爆裂性骨折合并椎体侧方脱位及2～4多发肋粉碎性骨折1例,肩胛骨骨折3例。皮下气肿16例,纵隔气肿4例,胸壁血肿1例,肝破裂2例,脾破裂3例,肾破裂1例,颈椎脱位及骨折2例,颅脑损伤4例。结论 CT检查较普通X线检查能提供更多的诊断信息,目前县级医疗机构均有螺旋CT,CT扫描费用也在大幅下调,所以对严重胸部外伤的患者应及时采用CT扫描,以及时明确病变的部位、性质、程度,迅速明确诊断,及时进行手术,挽救危重患者的生命。
Objective To investigate the value of CT scan in county-level medical institutions for severe thoracic trauma. Methods 16 cases of severe thoracic trauma in our hospital were scanned with 10-mm slice thickness and interval with a double-slice spiral CT with GEHispeed dual. Some of the lesions were reconstructed (thinned) and observed with image. Results Sixteen cases of severe thoracic trauma, including 10 pulmonary contusion, 2 lung laceration, 1 bronchial rupture, 2 atelectasis, 10 pulmonary collapse, 8 hemothorax, 3 pneumothorax, 3 pneumothorax, Chest in 5 cases; occurred in 16 cases of rib fractures, bilateral clavicular fracture in 2 cases, unilateral clavicular fracture in 3 cases, 3,4 thoracic burst fractures with lateral vertebral dislocation and 2 to 4 multiple crushing fractures in 1 case, Scapular fracture in 3 cases. Subcutaneous emphysema in 16 cases, mediastinal emphysema in 4 cases, chest wall hematoma in 1 case, liver rupture in 2 cases, splenic rupture in 3 cases, renal rupture in 1 case, cervical dislocation and fracture in 2 cases, head injury in 4 cases. Conclusion CT examination can provide more diagnostic information than ordinary X-ray examination. Currently, county-level medical institutions have spiral CT and CT scanning costs are also significantly reduced, so patients with severe chest trauma should be promptly adopted CT scan in time and clearly The location of the lesion, nature, extent, rapid and clear diagnosis, timely surgery to save critically ill patients.