创伤性连枷胸的临床特征与救治

目的　探讨创伤致连枷胸的损伤特征及救治。方法　回顾性分析 1997年 1月～2 0 0 2年 12月我科收治的 5 3例连枷胸患者的临床特点及诊治体会。行气管切开 12例 ,肋骨牵引 8例 ,手术内固定 18例 ,呼吸机治疗 10例 ,非固定治疗 5例。结果　治愈 49例 ( 92 .4% ) ,45例肺功能恢复正常 ;死亡 4例 ( 8.6% )。结论　在创伤性连枷胸患者中 ,肺挫伤和反常呼吸运动是引起呼吸和循环功能障碍的重要原因。保持呼吸道通畅 ,恢复胸壁的稳定性 ,治疗肺挫伤 ,积极救治复合伤是治疗的关键措施。

Clinical characteristics and treatment of traumatic flail chest

Objective To evaluate the characteristics and treatment of traumatic flail chest.Methods The clinical characteristics,diagnosis and outcome of 53 cases of flail chest in out unit from January 1997 to December 2002 were analyzed retrospectively.Tracheotomy was performed in 12 cases,rib traction in 8 cases,internal fixation of operation in 18 cases,mechanical ventilation in 10 cases,unfixation in 5 cases.Results There were 4 deaths (8.6%).Forty-nine cases(92.4%) were cured,and 45 of them recovered normal pulmonary function.Conclusion Pulmonary contusion and paradoxical respiratory movement were the important causes resulting in respiratory dysfunction of traumatic flail chest.The key of management was to ensure unobstruction of the air way,restore stability of the chest wall,treat pulmonary contusion and actively multi-injury.