BLUNT CHEST INJURIES IN 1696 PATIENTS

被引：73

作者：

GALAN, G ^{[1
]}

PENALVER, JC ^{[1
]}

PARIS, F ^{[1
]}

CAFFARENA, JM ^{[1
]}

BLASCO, E ^{[1
]}

BORRO, JM ^{[1
]}

GARCIAZARZA, A ^{[1
]}

PADILLA, J ^{[1
]}

PASTOR, J ^{[1
]}

TARRAZONA, V ^{[1
]}

机构：

[1] LA FE UNIV HOSP,THORAC SURG SERV,AVE CAMPANAR 21,E-46009 VALENCIA,SPAIN

来源：

EUROPEAN JOURNAL OF CARDIO-THORACIC SURGERY | 1992年 / 6卷 / 06期

关键词：

BLUNT CHEST TRAUMA; MANAGEMENT; RESULTS;

D O I：

10.1016/1010-7940(92)90143-L

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

We review 1696 patients with blunt chest trauma. Road traffic accidents were the main cause of injury followed by domestic falls and labour accidents. Outdoor falls and sport accidents accounted for a small number of injuries. For clinical evaluation, Stoddart's score was used. The injuries were considered as minor in 710 patients, intermediate in 740 and severe in 246. Global in-hospital mortality was low (5%) but increased to 37% when only patients with multiple severe injuries were considered. Thoracic wall fractures were present in 1419 patients. Flail chest was diagnosed in 140 patients and pulmonary contusion in 275. Diaphragmatic rupture was present in 40 patients and tracheobronchial injury in 6. Cardiovascular injuries occurred in 55 patients. Associated extrathoracic injuries were seen in 611 patients: 923 patients were clinically observed and/or medically treated. An intercostal tube was inserted in 638 patients. Thoracotomy was undertaken in 105 patients. Surgical fixation for flail chest was carried out in 29 patients. The results were generally good: 9 patients did not need any mechanical ventilation and 11 were ventilated for a short period. No deaths were due to the surgical procedure. The authors maintain that a selective attitude restricting, but not ignoring, surgical stabilization is the best policy.

引用

页码：284 / 287

页数：4

共 10 条

[1]

Besson A., Saegesser F., Chest trauma and associated injuries, (1982)

[2]

Blair E., Topuzlu Z., Davis J.H., Delayed or missed diagnosis in blunt chest trauma, J Trauma, 11, pp. 129-145, (1971)

[3]

LoCicero J., Mattox K.L., Epidemiology of chest trauma, Surg Clin North Am, 69, pp. 19-24, (1989)

[4]

Malloney J.W., Schumtzer K.J., Rascheke E., Paradoxical respiration and “Pendelluft, J Thorac Cardiovasc Surg, 41, pp. 291-298, (1961)

[5]

Paris F., Tarazona V., Blasco E., Canto A., Casillas M., Pastor J., Paris M., Montero R., Surgical stabilization of traumatic flail chest, Thorax, 30, pp. 521-527, (1975)

[6]

Paris F., Tarrazona V., Garcia-Zarza A., Controversial aspects of surgical fixation for traumatic flail chest, International trends in general thoracic surgery 7: Surgical management of chest injuries, pp. 231-239, (1991)

[7]

Ribet M., Woelffle D., Bolleingier D., Hassoun A., Pruvot F.R., Giard-Lefevre S., La contusion pulmonaire diffuse, La Presse Méd, 16, pp. 578-581, (1987)

[8]

Stoddart J.C., The ventilatory management of chest injuries, Trauma of the chest, pp. 14-19, (1977)

[9]

Trinkle J.K., Grover F.L., Blunt trauma to the chest wall, International trends in general thoracic surgery 2: Major challenges, pp. 231-239, (1987)

[10]

Wagner R.B., Jamieson P.M., Pulmonary contusion: Evaluation and classification by computed tomography, Surg Clin North Am, 69, pp. 31-41, (1989)

← 1 →