交通事故中55例连枷胸的临床特点与救治分析

目的分析交通事故中连枷胸的临床与救治特点.方法回顾性分析1994年10月～2002年8月我科收治55例交通事故中连枷胸患者的临床特点及诊治体会.5例行气管切开,27例行肋骨牵引,15例行胸骨和肋骨内固定.结果治愈46例(83.6%),42例肺功能恢复正常;死亡9例(16.4%).结论连枷胸常伴发于交通事故所致多发伤,休克发生率高;肺挫伤和“反常呼吸运动“是引起呼吸功能障碍的重要原因.保持呼吸道通畅、恢复胸壁稳 定性、治疗肺挫伤是治疗的关键措施,成人呼吸窘迫综合症(ARDS)是连枷胸死亡的主要原因.

The Clinical Characteristics and Therapeutic Analysis of 55 Cases of Flailest in Traffic Accident

Objective To analyze the characteristics and treatment of flail chest injury in traffic accident.Methods The clinical characteristics,diagnosis and therapeutic result of 55 cases with flail chest in our unit from October 1994 to August 2002 were analyzed retrospectively Tracheotomy was performed in 5 cases,rib tractions in 27 cases,internal fixations of sternum and rib in 15 cases.Results There were 9 deaths(16.4%),46 cases(83.6%) were cured,and 42 of them recovered normal pulmonary function.Conclusions The associated flail chest with polytrauma occurred commonly in traffic accident.The in- cidence of shock was high.Pulmonary contusion and paradoxical respiratory movement were the important causes resulting in respiratory dysfunction.The key of management was ensuring unobstruction of the air-way,recovering stability of the chest wall, effective treatment of pulmonary contusion.The hospital deaths were mainly caused by adult respiratory distress syndrome (ARDS)