Clinical analysis of thoracic exploration of chest trauma_Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Authors：

李揚 ^1,2 ,  楊異 ² , 吳偉銘 ² , 何偉偉 ²

1. ;
2. ;

Corresponding?author：

楊異, Email: dryangyi@aliyun.com

Keywords：

胸外傷; 開胸探查; 肺挫傷; 連枷胸

DOI：

10.7507/1007-4848.201601032

Video：

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目的探討胸外傷開胸探查的手術指征及救治策略。方法回顧性分析我院自 2006 年 1 月至 2014 年 12 月經開胸探查救治 51 例胸外傷患者的臨床資料，其中男 43 例、女 8 例，年齡 24（17～75）歲。結果全組損傷嚴重度評分（ISS）平均 19.4 分。閉合性損傷 16 例，開放性損傷 35 例，治愈 45 例（88.24%），死亡 6 例（11.76%）。死亡原因為心臟破裂、失血性休克、感染性休克、多器官功能障礙綜合征（MODS）、彌散性血管內凝血（DIC）。結論及時就醫、快速診斷、準確把握手術指征、多科室聯合診治是救治胸外傷的關鍵。

Citation： 李揚, 楊異, 吳偉銘, 何偉偉. Clinical analysis of thoracic exploration of chest trauma. Chinese Journal of Clinical Thoracic and Cardiovascular Surgery, 2017, 24(9): 735-737. doi: 10.7507/1007-4848.201601032 Copy

1.	黃繼江, 王保毅, 儲偉, 等. 胸外傷行開胸手術 26 例臨床分析. 醫學理論與實踐, 2004, 17(11): 1292.
2.	劉東平. 胸外傷急診開胸探查的手術配合. 中國現代醫學雜志, 2004, 14(18): 142.
3.	駱峰, 季惠, 林名圣. 開放性胸外傷臨床處理中電視胸腔鏡的應用. 南昌大學學報(醫學版), 2013, 53(1): 30.
4.	張健. 胸外傷 230 例臨床分析. 中華現代外科學雜志, 2007, 4(5): 130.
5.	母存富, 張熠, 張文林, 等. 外傷性心臟破裂 13 例救治體會. 中國胸心血管外科臨床雜志, 2015, 4(22): 388-390.
6.	Roberts J, Weigelt JA. A case study of a multiply injured patient. Surg Clin N(Am), 2012, 92(6): 1649-1660.
7.	Berg RJ, Okoye O, Teixeira PG, et al. The double jeopardy of blunt thoracoabdominal trauma. Arch Surg, 2012, 147(6): 498-504.
8.	Watins TR, Nathens AB, Cooke CR, et al. Acute respiratory distress syndrome after trauma: development and validation of a predictive mode. Crit Care Med, 2012, 40(8): 2295-2303.
9.	Perl M, Gebhard F, Brucrner UB, et al. Pulmonary contusion causes impairment of macrophage and lymphocyte immune functions and increase mortality with a subsequent septic chanllenge. Cri Care Med, 2005, 33(6): 1351-1358.
10.	Ferretti C. A prospective trial of poly-L-lactic/polyglyclic acid copolymer plates and screws for internal fixation of mandibular fractures. Int J Oral Maxillfac Surg, 2008, 37(3): 242-248.
11.	Granetzny A, El-Aal MA, Emam E. Surgical verus conservative treatment of flail chest Evaluation of the pulmonary status. Interact Cardiovasc Thorac Surg, 2005, 4(6): 583-588.
12.	Pettiford BL, Luketich JD, Landreneau RJ. The management of flail chest. Thorac Surg Clin, 2007, 17(1): 25-33.
13.	Balci AE, Eren S, Cakir O, et al. Open fixation in flail chest: review of 64 patients. Asian Cardiovasc Thorac Ann, 2004, 12(1): 11-15.
14.	Rocco G, Fazioli F, Martucci N, et al. Video-assisted thoracic surgery rib resection and reconstruction with titanium plate. Ann Thorac Surg, 2011, 92(2): 744-745.
15.	崔建國, 張文. 電視胸腔鏡治療外傷性血氣胸 31 例. 臨床肺科雜志, 2011, 16(4): 563.

1. 黃繼江, 王保毅, 儲偉, 等. 胸外傷行開胸手術 26 例臨床分析. 醫學理論與實踐, 2004, 17(11): 1292.
2. 劉東平. 胸外傷急診開胸探查的手術配合. 中國現代醫學雜志, 2004, 14(18): 142.
3. 駱峰, 季惠, 林名圣. 開放性胸外傷臨床處理中電視胸腔鏡的應用. 南昌大學學報(醫學版), 2013, 53(1): 30.
4. 張健. 胸外傷 230 例臨床分析. 中華現代外科學雜志, 2007, 4(5): 130.
5. 母存富, 張熠, 張文林, 等. 外傷性心臟破裂 13 例救治體會. 中國胸心血管外科臨床雜志, 2015, 4(22): 388-390.
6. Roberts J, Weigelt JA. A case study of a multiply injured patient. Surg Clin N(Am), 2012, 92(6): 1649-1660.
7. Berg RJ, Okoye O, Teixeira PG, et al. The double jeopardy of blunt thoracoabdominal trauma. Arch Surg, 2012, 147(6): 498-504.
8. Watins TR, Nathens AB, Cooke CR, et al. Acute respiratory distress syndrome after trauma: development and validation of a predictive mode. Crit Care Med, 2012, 40(8): 2295-2303.
9. Perl M, Gebhard F, Brucrner UB, et al. Pulmonary contusion causes impairment of macrophage and lymphocyte immune functions and increase mortality with a subsequent septic chanllenge. Cri Care Med, 2005, 33(6): 1351-1358.
10. Ferretti C. A prospective trial of poly-L-lactic/polyglyclic acid copolymer plates and screws for internal fixation of mandibular fractures. Int J Oral Maxillfac Surg, 2008, 37(3): 242-248.
11. Granetzny A, El-Aal MA, Emam E. Surgical verus conservative treatment of flail chest Evaluation of the pulmonary status. Interact Cardiovasc Thorac Surg, 2005, 4(6): 583-588.
12. Pettiford BL, Luketich JD, Landreneau RJ. The management of flail chest. Thorac Surg Clin, 2007, 17(1): 25-33.
13. Balci AE, Eren S, Cakir O, et al. Open fixation in flail chest: review of 64 patients. Asian Cardiovasc Thorac Ann, 2004, 12(1): 11-15.
14. Rocco G, Fazioli F, Martucci N, et al. Video-assisted thoracic surgery rib resection and reconstruction with titanium plate. Ann Thorac Surg, 2011, 92(2): 744-745.
15. 崔建國, 張文. 電視胸腔鏡治療外傷性血氣胸 31 例. 臨床肺科雜志, 2011, 16(4): 563.

Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Clinical analysis of thoracic exploration of chest trauma

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