胸部创伤救治现状

伤后数分钟到数小时内的早期救治是提高胸部创伤救治水平的关键.胸部创伤后的病理生理变化主要包括低氧血症、高碳酸血症和酸中毒.紧急情况下胸部创伤诊断与复苏同时进行,根据体征、诊断性胸腔穿刺或X 线片作出;血流动力学状况稳定时,则应全面检查避免漏诊危险的隐匿性损伤,有条件时应首选采用多层螺旋CT.胸部创伤急救应遵循高级创伤生命支持的原则,多数胸部创伤可采用临床观察、胸腔穿刺或引流、呼吸支持、止痛和介入治疗等处理治愈;小部分胸部创伤的病人在复苏阶段需行紧急手术干预.

Advances of care of thoracic trauma

Early care during several minutes and hours after injury is the key point of elevating the level of care of thoracic trauma. The main pathophysiology after thoracic trauma includes hypoxemia,hypercapnia and acidosis. At urgent situation, the patient should be diagnosed by physical signs, diagnostic thoracentesis and X-rays, and rescued simuhaneously. If the hemodynamics state is stable,the patient should be examined overall for avoiding missed diagnosis of hazardous delitescent injuries and multi-spiral CT should be used firstly in suitable condition. Emergency treatment of thoracic trauma should follow advanced trauma life support, the majority of patients with thoracic trauma can be managed conservatively, such as clinical observation, thoracentesis or drainage, respiration support, odynolysis and interventional therapy et al. only a small but significant number requires emergency thoracotomy as part of their initial resuscitation.