40例肺挫伤的临床诊断与治疗

目的探讨肺挫伤患者的临床诊断和有效治疗方法。方法回顾分析40例肺挫伤患者的临床资料,患者入院后经胸部X线、CT检查确诊为肺挫伤。早期合理使用激素、抗生素,充分有效的止痛,有效给氧,必要时气管切开、机械通气,保持呼吸道通畅,防治休克、维持循环稳定并及时处理合并损伤,注意控制输液量,尤其是限制晶体液的摄入量,采用限制性液体复苏。结果 40例患者治愈35例,治愈率87.5%,死亡5例,病死率为12.5%。死亡原因:多根多处肋骨骨折伴发严重肺挫伤及ARDS 3例;1例死于合并脑挫裂伤;1例死于多器官功能衰竭。结论肺挫伤的诊断首选胸部CT检查。严重合并伤和并发症是肺挫伤的主要死亡原因。积极救治合并伤,合理的胸壁固定,限制性液体复苏及保护性机械通气是提高肺挫伤疗效的重要途径。

Clinical diagnosis and treatment of 40 patients with pulmonary contusion

Objective To study the clinical methods of diagnosis and effective treatment of patients with pulmonary contusion.Methods Retrospective analysis of our hospital admitted in 40 cases clinical data of patients with pulmonary contusion.Admitted Hou by chest x line,and CT check confirmed for lung contusion.Early reasonable using hormone,and antibiotics,full effective of pain,effective to oxygen,necessary Shi tracheal incision,and machinery ventilation,maintained respiratory smooth,control shock,and maintained cycle stability and timely processing merged injury,attention control infusion volume,especially limit Crystal liquid of intake volume,used restrictive liquid recovery.Results Cure of 35 cases of 40 patients,cure rate of 87.5%,5 deaths,with a case fatality rate 12.5%.Cause of death:multiple fractures of multiple ribs and ARDS3 cases with severe pulmonary contusion;1 case died of cerebral contusion and laceration;1 case died of multiple organ failure.Conclusion Chest CT in diagnosis of pulmonary contusion preferred checking.Serious associated injury and complications are the main cause of death pulmonary contusion.Active treatment of combined injury,chest wall fixing of reasonable,limited fluid resuscitation and protective mechanical ventilation is the important way to improve the curative effect of pulmonary contusion.