258例胸部创伤的临床诊治体会

目的总结探讨胸部创伤诊断治疗的经验与体会。方法对近5年所收治的258例胸外伤病例的诊断治疗方法进行回顾性总结分析。结果全组治愈250例，开胸手术31例，同时进行其他外科手术25例，死亡8例，死亡率3．1％，死亡原因主要是严重胸外伤尤其损伤心脏大血管，或合并重度颅脑、腹部重要脏器损伤，以及术后多器官功能衰竭。结论胸部严重损伤尤其心脏大血管损伤或者合并颅脑及腹腔重要脏器损伤时，极易导致循环呼吸功能紊乱，病情危急而复杂，死亡率很高，对于有严重合并伤的患者及时全面有效的诊治措施是救治成功的关键，短时间多科共同参与进行多种救命手术是降低死亡率的重要保证。

The clinical diagnosis and treatment experience of 258 chest wounded cases

Objective To summarize and discuss the experience of the diagnosis and treatment of chest trauma. Methods We analyzed the diagnosis of the 258 cases of chest trauma which we have treated for nearly 5 years retrospectively. Results 250 cases were cured,31 cases accepted thoracic surgery,25 eases were given other surgical operation,and eight cases were dead. The death rate was 3.10%. The main cause of death was the serious chest trauma, especially cardiovascular damage with severe brain or important intra-abdominal organ injury and multiple organ failure after operation. Conclusion Severe chest injury, in particular, cardiovascular and combined brain injury or important intra-abdominal organ injury, easily lead to circulatory and respiratory function disorders. It＇ s in critical and complex condition, and the mortality rate is very high. Timely and roundly measures of diagnosis and treatment are key to the success of treatment for patients with serious associated injury, and a number of departments involved in a variety of life-saving surgery together in a short period of time is an important guarantee to reduce mortality.