胸部穿透伤外露伤器拔除时机探讨

目的 探讨胸部穿透伤外露伤器的最佳拔除时机。方法 根据1280例胸部穿透伤中42例伤器外露的临床资料，结合观察西班牙斗牛过程的启示，探讨外露伤器最佳拔除时机。结果 4例心脏穿透伤未拔除伤器者到达医院时均死亡；38例胸部穿透伤患者中外露伤器于手术前拔除者35例(92％)治愈。结论 除胸部贯通伤外露伤器固定无移动者外，其他心脏、胸部盲管伤或胸腹联合伤外露伤器均宜尽早拔除。

Critical moment to extract the penetrating foreign body with an exposed free end on the chest wall

Objective To evaluate the critical moment to extract the penetrating foreign body with an exposed free end on the chest wall. Methods In a group of 1 280 cases of penetrating wound of the chest, 42 had an exposed free end of foreign bodies including various kinds of knives and daggers on the chest wall. The data of 42 cases were analyzed retrospectively together with the enlightenment through observation of the ox-fighting in Spain and the critical moment to extract the foreign body with an exposed free end on the chest wall advocated. Results None of these four penetrating wounds of the heart with a retained mortal object survived. Among 38 cases of penetrating wound of the chest, 35 had their mortal object extracted before the induction of anesthesia and all healed, with a cure rate of 92%. Conclusion For cases of penetrating wound of the chest, all the foreign body with an exposed free end on the chest wall should be extracted as early as possible except for those with mortal object well fixed on the chest wall without any possibility of movement during the course of transference.