胸部外伤328例治疗体会

目的．分析胸部外伤患者的临床特点和治疗。方法对328例胸部外伤患者的致伤原因、损伤类型及治疗方法进行回顾性分析。结果致伤原因以交通事故、锐器伤及高处坠落伤为主（86．6％）；损伤类型主要表现肋骨骨折（69．2％），合并肺挫伤及血气胸；全组以非手术及胸腔闭式引流治疗为主（79．3％），治愈319例（97．3％），死亡9例（2．7％）。结论大部分胸部外伤经非手术及胸腔闭式引流治疗可治愈；电视胸腔镜（VATS）手术创伤小并可及时明确诊断，应早期选用；及早有效治疗多脏器复合伤、连枷胸、肺挫伤以及急性呼吸窘迫综合征等严重并发症，能提高严重胸部外伤患者的生存几率。

Experience of treatment of 328 patients with chest trauma

Objective To analyze the clinical characteristics and treatment of chest trauma. Methods The causes of injury, types of injure and treatment in 328 patients with chest trauma were analyzed retrospectively. Results The main causes of injury were traffic accident, blunt injury and high fall injury （ 86.6% ）. Types of injury were mainly rib fracture （ 69.2% ） complicated with pulmonary contusion and hemopneumothorax. All patients mainly received non - operative treatment and thoracic closed drainage （79.3 % ）. Among them,319 cases were cured （97.3%） and 9 cases were dead （2.7%）. Conclusion Most of chest trauma can be cured by non - operative treatment and thoracic closed drainage. Video - assisted thoracoscopic surgery （VATS）has the advantage of slight trauma with an accurate diagnosis, so it should be used early. Two or more system injury, flail chest, pulmonary contusion and some severe complications such as ARDS （acute respiratory distress syndrome ） should be treated timely and effectively in order to improve the survival rate in patients with severe chest trauma.