成功救治胸部创伤326例分析

目的 :总结胸部创伤的诊治经验。方法 :对 17年内成功救治的 32 6例胸部创伤病例进行分析。结果 :病因以钝性伤多见。 2 6 3例并发血气胸 ,创伤性湿肺 135例 ,连枷胸 41例。行常规开胸手术 45例 ,电视胸腔镜手术 9例。临床治愈 30 1例 ,治愈率 92 3% ,好转 2 5例。结论 :连枷胸的治疗重点是针对肺挫伤进行综合治疗。对大面积严重浮动胸壁 ,仍需作必要的固定。正确掌握保守与手术治疗的界限对提高抢救成功率十分重要。电视胸腔镜对胸部创伤的诊治明显具有组织损伤小、康复快的特点

SUCCESSFUL TREATMENT OF CHEST TRAUMA (REPORT OF 326 CASES)

Objective:To review the experience of the diagnosis and treatment of chest trauma.Method:From August 1982 to September 1999,326 patients with chest trauma were treated successfully.There were 274 males and 52 females with a mean age of 35 years (range 3 to 77 years).The causes of injuries were mainly road traffic accidents,fall and assault ect.Traumatic wet lung and flail chest appeared in 135 and 41 patients respectively.45 cases underwent exploratory thoracotomy.9 cases were performed by video-assisted thoracoscopic surgery (VATS).Result:To traumatic flail chest,the treatment of lung contusion was very important.In the condition of extensive chest wall malacia,the fixation of chest wall was also essential.VATS procedure had the advantages of minor operating injury and recovery quickly.Conclusion:Early diagnosis and treatment shoud be emphasized.The application of VATS was being spread in this area.