胸部外伤246例诊治分析

分析我院1995—01～2003—01收治的246例胸部外伤患者的临床资料，探讨其早期诊断和处理，以提高救治率、改善病人生存质量。     

779例胸外伤分析

分析779例胸外伤损伤类型、受伤程度及变化特点。交通环境、治安状况、人员流动和安全意识是胸外伤的主要影响因素。提示应高度重视病人合并伤的存在。     

189例胸部创伤救治分析

报告189例胸部创伤的救治结果,对胸部创伤的致伤及死亡原因、早期诊断及处理和治疗原则进行了讨论。     

270例严重胸部伤治疗分析

２７０例严重胸部伤治疗分析徐志飞，孙耀昌，答作为，万国泰，李建秋，高光强我院自１９７６年至１９９２年共收治严重胸部伤２７０例，现将本组病人的救治情况分析如下。临床资料性别和年龄：男性２０３例，女性６７例。４０岁以下１０１例，４１～６０岁１０４例，６０...     

胸部外伤362例诊治分析

收治胸部外伤362例,分析其损伤原因、类型、损伤程度、合并症、处理方法及结果。其中非手术治疗330例,手术32例。174例发生胸内并发症,除1例死亡外,均恢复良好。     

格尔木地区胸部创伤320例分析

由于格尔木地区大气压与吸入氧分压（P：O2）均明显低于平原，胸部创伤尤其是严重胸部创伤，由于受伤本身及高原缺氧双重影响，临床表现与血气分析检查结果与平原地区显著不同[1]，病情急且发展快，治疗困难，死亡率较高，如抢救措施不及时，病人将很快死于进行性低氧血症[2]。本文总结分析了我科1986～1994年收治的320例胸部创伤病人，现将治疗体会报告如下：临床资料1一般资料1．1年龄与性别：共320例，其中男性236例，女性84例。年龄8～66岁，平均34岁，受伤至入院时间最长用天，最短半小时，平均4．5小时。1．2受伤原因：刀伤94例，车…     

小儿胸部创伤69例

１９６１～１９９７年我院收治胸部创伤患儿６９例。现将其治疗结果报告如下。临床资料１．一般资料：本组共６９例。其中男４９例,女２０例;３～７岁１２例,８～１２岁２４例,１３～１５岁３３例,平均年龄１１岁。致伤原因：车祸伤３５例,锐器伤１７例（刀刺伤１５...     

胸部开放性创伤的治疗（附183例临床分析）

胸部开放性创伤的治疗（附１８３例临床分析）王道庄笔者总结１９８０年６月～１９９２年１２月收治的胸部开放性创伤患者１８３例，对剖胸手术指征及手术提出见解。临床资料男１７２例，女１１例；年龄１１０／１２～６５岁，其中１５～３０岁１３９例占７６．０％。伤因...     

胸廓内血管损伤10例临床分析

对胸廓内血管损伤10例的诊治进行回顾性分析。探讨如何提高其救治水平。对胸骨旁投射区域内的穿透性损伤应考虑有合并胸廓内血管损伤的可能。     

胸部创伤486例救治体会

总结胸部创伤486例救治经验。本组治愈452例,死亡34例。早期诊断、正确处理及把握手术时机是提高胸部创伤治愈率的关键。     

96例严重胸腹部血管损伤的早期救治分析

目的探讨严重胸腹部血管损伤的早期诊治方法。方法2000年1月～2008年10月收治严重胸腹部血管损伤96例,其中26例到达急救部时表现明显失血性休克,经胸或腹腔穿刺抽出较多不凝血,立即送手术室紧急手术确诊;45例经64排螺旋CT及血管造影（CTA）检查确诊;25例经数字减影血管造影检查确诊。58例行手术治疗,其中45例行血管损伤缝合修补,手术前12例行血管造影后球囊血管阻断;13例行人造血管吻合,其中3例因伤情太重而行损害控制,即严重破损血管临时插管分流,患者术后在ICU复苏待全身情况改善后于术后48小时内再行血管吻合手术。38例（盆腔腹膜后血管损伤34例,其他4例）行动脉栓塞治疗。结果85例救治成功,救治成功率85．5％。发生严重并发症38例,其中脓毒症6例,急性呼吸窘迫综合征（ARDS）9例,多器官功能障碍综合征（MODS）23例。11例死亡,其中9例于伤后12小时内死亡,主要原因为多脏器严重损伤及失血性休克;2例于创伤后8天及16天死亡,主要原因为脓毒症及MODS。结论胸腹部血管损伤后应快速完成检查及诊断,紧急手术行血管修复或吻合,部分腹部血管损伤及盆骨折引起的腹膜后血管损伤可用动脉栓塞治疗。     

胸部穿透伤234例救治体会

目的 探讨胸部穿透伤的诊治方法和效果.方法 回顾性分析我科2000年1月～2006年12月收治的胸部穿透伤234例的临床资料.非手术治疗164例,胸腔穿刺11例,胸腔闭式引流106例.手术治疗70例(29.9%),其中51例在入院后1小时内手术,急诊室剖胸2例,术前安放胸腔闭式引流51例.剖胸探查40例,肺脏及支气管手术40例,心脏及大血管手术18例.剖腹探查19例,肝脾手术18例,胃肠手术17例.剖腹 剖胸2例.结果 本组治愈227例(97.0%).死亡7例(3.0%),其中4例未来得及手术死于失血性休克;手术组分别因多心腔伤、ARDS和肺部感染术后死亡3例.结论 胸部穿透伤比钝性伤较多需要手术,也比钝性伤有较好预后;诊断处理是否及时准确往往比伤情本身更影响生存率.     

道路交通事故致胸部损伤813例救治体会

目的 总结道路交通事故致胸部损伤的救治经验.方法 回顾分析2002年1月～2009年12月收治的道路交通事故致胸部损伤(AIS≥3分)病例813例的临床资料.结果 本组伤员中汽车驾驶员239例,行人308例,乘员132例,摩托车驾驶员129例,骑自行车人5 例.其中心脏损伤182例(22.4%),连枷胸171例(21%...     

Traumatic injuries: imaging of thoracic injuries

Chest trauma is one of the most important causes of death, in particular in individuals under the age of 40 years. The mortality rate for chest trauma, often related to motor vehicle accidents, is approximately 15.5%; it increases dramatically to 77% with associated shock and head injury (Glasgow scores of 3-4). The accurate diagnosis of pathologies consequent to blunt chest trauma depends on a complete knowledge of the different clinical and radiological manifestations. The first diagnostic approach is classically based on chest X-ray often carried out on supine position at the hospital admission. A CT study must then be performed in all chest trauma patients in whom there is even the smallest diagnostic doubt on plain film. In particular, spiral CT (SCT) assumes a fundamental role in the demonstration of mediastinal hemorrhage and direct signs of aortic lesions. At present, SCT is routinely part of a diagnostic evaluation which also includes scans of the brain and the abdomen in polytraumatized patients. Magnetic resonance is the ideal method for visualizing diaphragmatic lesions. Furthermore, recent reports have demonstrated the high diagnostic value of MR in evaluating aortic injuries. The purpose of this article is to review the most common radiological patterns related to chest trauma.     

X-ray computed tomography of thoracic injuries. Apropos of 40 cases]

On chest radiographs, the precise assessment of thoracic injuries consecutive to blunt trauma is often compromised by the nonspecific appearance of many lesions. Furthermore, significant injuries are frequently overlooked. However, the management of the patients with chest trauma is still often based primarily upon clinical and radiographic findings and Computed Tomography (CT) is often performed secondarily on the basis of unexplained clinical signs or suspected radiographic abnormality. Some authors have reported that CT was a highly sensitive method for detecting thoracic lesions frequently not seen or underestimated on conventional supine chest radiographs. However, the value that these new CT findings could have in the therapeutic management of these patients, have not been systematically investigated to our knowledge, except in a limited series suggesting that the course of critically ill patients could be substantially altered after thoracic CT. In order to estimate the role of early CT in the management of patient care, we report the therapeutic consequences of CT findings in forty patients who we report the therapeutic consequences of CT findings in forty patients who had a thoracic CT within few hours following a chest injury. We showed that early thoracic CT scan in patients with blunt trauma detected significantly more lesions than did chest X-Ray and appreciably modified the treatment modalities in 70% of our patients. We then recommend that all the patients admitted in ICU after chest trauma undergo a thoracic CT scan as soon as possible in order to optimize their treatment modalities.     

Radiologic diagnosis of thoracic injuries

A radiological check list in trauma of the thorax is presented that is oriented by means of topographic locations (thoracic wall, pleura, lung, mediastinal organs). Focus is on the specific features of lung contusion and lesions of the mediastinal organs with special reference to modern examination methods.