胸外伤救治及护理

目的　分析胸外伤特点 ,提高救治中的护理成功率。方法　对 12 5 1例胸外伤患者的伤情进行分析 ,总结护理经验。结果　经积极治疗和护理后有 12 2 9例患者存活 (占 98.2 % ) ,死亡 2 2例 (占 1.8% ) ;在死亡人数中 ,按胸伤及合并伤的伤情分为 :心脏大血管损伤死亡 3例 (占 13.6 % ) ,胸腹联合伤死亡 4例(占 18.2 % ) ,胸伤合并多部位伤死亡 13例 (占 5 9.1% ) ,其它死亡 2例 (占 9.1% ) ;若按治疗时间分为 :早期失血性休克死亡 4例 (占 18.2 % ) ,严重颅脑伤死亡 3例 (占 13.6 % ) ;中晚期呼吸窘迫综合征 (ARDS)死亡 6例 (占 2 7.3% ) ,多脏器功能不全死亡 5例 (占 2 2 .7% ) ,心力衰竭死亡 3例 (占 13.6 % ) ,中毒性休克死亡 1例 (占 4 .5 % )。结论　胸外伤死亡率较高 ,救治及护理过程均需综合考虑 ,处理分轻重缓急 ,并注意合并伤 ;同时加强对并发症的防治

Emergency treatment and nursing of thoracic injury

Objective To analyse the characteristics of thoracic injury and improve the success rate of nursing in rescue and treatment.Methods The injury conditions of 1 251 such cases wereanalyzed for summing up nursing experiences.Results With active treatment and nursing,1 229 cases survived(98.2 %) while 22 cases died( 1.8 %);according to the conditions of chest injury and combined injury of the dead cases,3 cases were caused by injury of heart great vessels(13.6 %),and 3 cases was caused by combined thoracic-abdominal injury(18.2 %),and another 13 cases were by thoracic injury combined with multiple-site injury(59.1 %),finally 2 cases were by other causes(9.1 %).According to the time,the causes were respectively early-stage hemorrhagic shock(4 cases, 18.2 %),severe craniocerebral injury(3 cases,13.6 %),mid-late stage ARDS(6 cases,27.3 %),insufficiency of multiple organs(5 cases,22.7 %),heart failure(3 cases,13.6 %) and toxic shock(1 case,4.5%).Conclusion With high death rate,the rescue and nursing of thoracic injury needs general consideration and cases must be treated according to the urgency.Meanwhile combined injury,and prevention and cure of complications should also be noticed.