重症小儿胸部损伤诊治的临床观察

目的 探讨重症小儿胸部损伤的诊断治疗原则.方法 回顾分析1998年3月～2007年10月收治的117例重症胸部损伤患儿,其中男83例(71%),女34例(29%),车祸伤50例,锐器伤46例,高处坠落伤15例,挤压伤4例,枪弹伤2例.发生休克29例(32%).92例(79%)给予胸腔闭式引流等保守治疗,25例(21%)接受剖胸手术.结果 109例(93%)患儿治疗后恢复良好,8例(7%)死亡,均为多发伤,其中手术中死亡2例,分别为合并颅脑损伤和脾破裂.结论 小儿胸部损伤病情多样,正确及时的诊治措施是抢救患儿生命的关键.

Diagnosis and treatment of severe thoracic trauma in children

Objective To discuss the principles of the diagnosis and treatment of severe thoracic trauma in children. Methods Retrospective analysis was performed on 117 children with severe thoracic trauma treated in our department during March 1998 and October 2007. The patients included 83 boys(71%) and 34 girls(29%). They included 50 with traffic accident injury, 46 with sharp force injury, 15 with falling injury, 4 with crush injury, and 2 with gun injury, respectively. Shock was complicated in 25 cases (32%). Among all 117 patients, 92 were treated with conservative methods such as thoracic close drainage, while 25 were undertaken operation. Results Eight children (7%) died from complicated injuries, including 2 during operation from severe brain injury and spleen rupture. All the others were recovered uneventfully without any complications. Conclusions Since thoracic trauma in children shows sophisticated characteristics, suitable initial aid is essential to reduce mortality and improve the prognosis.