重度胸部损伤182例救治体会

目的 探讨重度胸部损伤的诊断及救治方法,提高重度胸部损伤的抢救成功率.方法 对2000～2009年收治的182例重度胸部损伤的临床资料进行回顾性分析总结.结果 治愈160例,死亡22例,病死率为12.1%,死亡原因主要为合并其他重要器官损伤、术后急性呼吸窘迫综合征（14例）和多器官功能衰竭（8例）.结论 重度胸部损伤（尤其是合并重度颅脑损伤、肝脾破裂大出血）临床特点为伤势严重、呼吸困难、循环紊乱、休克、低氧血症、意识障碍、病死率高.救治原则是尽快明确诊断,尽快恢复呼吸循环稳定,及早手术治疗,优先处理致命伤,积极防治并发症.

Experience of treatment in the 182 patients with severe chest injury

Objective To search the ways of diagnosis and treatment of the severe chest injury and raise the rescue success rate. Methods The clinical data were retrospetively analyzed on the 182 patients with severe chest in- jury treated in our hospital from 2000 to 2009. Results One hundred and sixty patients with severe chest injury were cured but 22 died,the death rate was 12. 1%. The main causes of death included the injury combined with other im- portant organ, acute respiratory distress syndrome after operation （14 patients ） or multiple organ failure （8 patients ）. Conclusion Severe chest injury, especially combined with severe craniocerebral injury or liver and spleen nature and hemorrhage, that has the clinical features such as severe damage, dyspnea, circulation disorders, shook, hypoxia, or a high mortality rate. The principle of the treatment is making a definite diagnosis, restoring the respiratory and circulatory stability, applying surgical treatmen as soon as possible, dealing with a fatal wound quickly and controlling complications positively.