急性胸部创伤的影像分析

目的：是通过193例车祸急性胸部创伤的认识，提高影像学诊断水平；方法与材料：本组病例全部收集于1998年3月至2003年10月车祸病例，有完整的病历和良好的X线照片。对胸部影像特征和发生机理及病理改变进行分析讨论；结果：根据影像学表现有骨折142例，占73.58％，湿肺109例，占56．48％，血肿11例，占5.70％，肺撕裂伤6例，占3．11％，气胸27例，占13．99％，液气胸24例，占12．44％，创伤膈疝7例，占3．63％，膈创伤12例，占6．22％，纵膈及皮下气肿58例，占30．05％，胸膜反应增厚粘连59例，占30．57％。结论：所有车祸急性胸部创伤都有影像学特征表现，只要结合临床，有助于提高诊断准确性。     

胸部创伤的比较影像分析

胸部创伤性疾病在日常工作中，所占比重较大。就其致病原因和伤情，可分开放性和闭合性两大类，前者在战时及偶发事故中可见，闭合性损伤包括压伤、挤伤、摔伤、撞伤及爆伤等。按胸部解剖和影像学所见，可将胸部创伤分为胸壁与胸膜创伤、肺部创伤、纵膈创伤和横膈创伤等，而影像学(X线、CT及MRI)检查对于明确伤情，及时治疗有较大的帮助。     

胸部闭合性创伤并发ARDS的诊治分析

总结两院收治的11例胸部闭合性创伤并发ARDS的诊治经验，旨在提高此类疾病的救治水平。     

193例车祸急性胸部创伤的影像分析

通过186例车祸急性胸部创伤的认识，提高影像学诊断水平；方法与材料：本组病例全部收集于1998年3月至2003年10月车祸病例，有完整的病历和良好的X线照片。对胸部影像特征和发生机理及病理改变进行分析讨论；结果：根据影像学表现有骨折142例，占73．58％，湿肺109例，占56．48％，血肿11例。占5．70％，肺撕裂伤6例，占3．11％，气胸27例，占13．99％，液气胸24例，占12．44％，创伤膈摘7例，占3．63％，膈创伤12例，占6．22％，纵膈及皮下气肿58例，占30．05％，胸膜反应增厚粘连59例，占30．57％；结论：所有车祸急性胸部创伤都有影像学特征表现，只要结合临床，有助于提高诊断准确性。     

胸部闭合性创伤376例诊治分析

我院近十年来共收治胸部伤487例,闭合性创伤376例,占77％。现就诊断及救治情况分析如下:1 临床资料1.1一般资料本组男性285例,女性91例;年龄7-73岁,平均46.7岁。交通事故伤237例,占63％;高处坠落伤83例,占22.1％;钝器击伤47例,占12％;重物挤压伤9例,占2.4％。     

电视胸腔镜在部分少见胸部创伤中的应用

自1995年1月-2004年12月，笔者使用电视胸腔镜手术（video—assisted thoracic surgery，VATS）治疗385例胸部创伤患者，其中处理部分少见胸部创伤10例，效果满意。现报告如下。     

胸部创伤的影像诊断分析

胸部创伤一般多为暴力挤压、冲撞或钝器碰击胸部所引起，也可因利器刀锥、火器弹片等穿破胸壁所致，胸部创伤可分为闭合性和开放性两大类。     

胸部外伤50例患者X线征象及动态观察

100039;2武警总院放射科,北京100039)胸部在直接或间接的暴力下均可发生肺挫伤、撕裂伤骨折等,严重者会危及患者生命。因此,及时准确地作出X线诊断,对减轻患者的痛苦、挽救患者生命有着非常重要意义。对胸部外伤的动态观察有助于了解病变的吸收治愈过程,为临床医师提供可靠的诊     

Imaging of blunt chest trauma

In western European countries most blunt chest traumas are associated with motor vehicle and sport-related accidents. In Switzerland, 39 of 10,000 inhabitants were involved and severely injured in road accidents in 1998. Fifty two percent of them suffered from blunt chest trauma. According to the Swiss Federal Office of Statistics, traumas represented in men the fourth major cause of death (4 %) after cardiovascular disease (38 %), cancer (28 %), and respiratory disease (7 %) in 1998. The outcome of chest trauma patients is determined mainly by the severity of the lesions, the prompt appropriate treatment delivered on the scene of the accident, the time needed to transport the patient to a trauma center, and the immediate recognition of the lesions by a trained emergency team. Other determining factors include age as well as coexisting cardiac, pulmonary, and renal diseases. Our purpose was to review the wide spectrum of pathologies related to blunt chest trauma involving the chest wall, pleura, lungs, trachea and bronchi, aorta, aortic arch vessels, and diaphragm. A particular focus on the diagnostic impact of CT is demonstrated. Received: 29 November 1999; Accepted: 28 January 2000     

Acute tamponade after blunt chest trauma

We report a case of high-impact blunt chest trauma resulting in bilateral lung contusion and rupture of the right atrial appendage with subsequent hemopericardium leading to acute right heart failure. Although tamponade remains a clinical diagnosis, in this case CT findings confirmed the diagnosis, initially unsuspected, which led to successful therapeutic intervention. We believe that in patients with high-velocity trauma and possible blunt injury to the chest, a cardiac injury should always be searched for and excluded.     

胸部钝器伤与锐器伤临床特点比较

目的比较胸部钝器伤与锐器伤不同临床特点,探讨相应的处理方式。方法对132例胸部钝器伤和50例锐器伤患者的临床资料进行回顾分析,并比较两者的不同表现和处理特点。结果钝器伤患者治愈128例,死亡4例,其中2例死于双侧严重肺挫伤,2例死于多系统损伤所致的多脏器功能衰竭。锐器伤治愈48例,死亡2例,其中1例在急诊手术的麻醉过程中死亡,1例在术后第2d死于多脏器功能衰竭。结论钝器伤患者大部分通过保守治疗及胸腔闭式引流可以达到治疗目的,而锐器伤患者肋间血管损伤及肺裂伤多见,且易伴发心脏大血管损伤、膈肌破裂及腹腔脏器损伤,开胸探查指征应适当放宽,特别是伴有呼吸、循环功能障碍倾向者,在抗休克的同时应尽早开胸手术。     

胸部创伤的X线诊断分析

近年来,随着交通及其他意外事故的频繁发生,胸部创伤患者日渐增多。胸部在直接或间接暴力作用下,均可发生损伤的可能。因此,X线检查对其有着重要意义,现将我院近几年来资料完整的胸部创伤患者100例结合文献分析讨论,以期提高对胸部创伤各种影像表现的认识与理解。     

Multi-detector computed tomography imaging of blunt chest trauma

Background and purpose

Chest trauma is a significant cause of mortality and morbidity, especially in the younger population. The purpose of this study was to evaluate the role of multi-detector computed tomography (MDCT) in the assessment of patients with blunt chest trauma.

Patients and methods

A prospective study was conducted on thirty (30) patients with blunt chest trauma (21 males and 9 females, aged from 6 to 62 years) and 29 control patients presented with any trauma other than blunt chest trauma (23 males and 6 females, aged from 10 to 68 years) at the Emergency Department, Tanta University Hospital, from January 2013 to February 2014. Cases were subjected to clinical evaluation and radiological assessment of the chest using conventional chest X-ray (CXR) and multi-detector computed tomography.

Results

The most common mode of injury was motor vehicle accidents (56.7%). On MDCT scan, the frequency of chest injuries were; chest wall injuries (86.7%), pleural injuries (80%), parenchymal injuries (56.7%), mediastinal injuries (30%) and finally the dorsal spine injuries (16.7%). MDCT is more sensitive, specific, and accurate than CXR in the assessment of blunt chest trauma and management of patients.

Conclusion

MDCT is the modality of choice for rapid assessment of emergency chest trauma patients, when chest X-ray was inconclusive.