国际外科学杂志
國際外科學雜誌
국제외과학잡지
INTERNATIONAL JOURNAL OF SURGERY
2013年
7期
458-461
,共4页
李少民%张晋%姜建涛%乔哲%周斌%张潍%孔冉冉%马跃峰
李少民%張晉%薑建濤%喬哲%週斌%張濰%孔冉冉%馬躍峰
리소민%장진%강건도%교철%주빈%장유%공염염%마약봉
重症胸外伤%内固定器%ARDS%连枷胸%外科手术
重癥胸外傷%內固定器%ARDS%連枷胸%外科手術
중증흉외상%내고정기%ARDS%련가흉%외과수술
Severe thoracic injury%Internal fixations%ARDS%Flail chest%Surgical procecheres,operative
目的 探讨重症胸外伤合并胸壁软化不同手术时机的临床疗效.方法 对比研究了49例重症胸外伤救治的临床资料,包括治疗前后动脉血气、氧合指数、基础生命体征变化、疼痛程度、手术时间、平均住院日、机械通气辅助时间、急性呼吸窘迫综合征病死率以及胸片情况.结果 早期手术26例患者全部存活,无一例死亡,胸片改善时间最快治疗后第3天,最长第9天效果满意;晚期手术23例患者1例死亡.两组患者血气分析显示:SAT、PO2、PCO2、PaO2/FiO2在手术后均有显著改善,与术前比较均有显著差异.疼痛程度手术后明显减轻、主动咳嗽增加.结论 创伤性连枷胸患者早期行手术内固定治疗,辅以呼吸机辅助呼吸,可大大改善患者的缺氧状况,减少气管切开,缩短呼吸机辅助时间,明显缩短恢复期,并未加重肺损伤和增加病死率.
目的 探討重癥胸外傷閤併胸壁軟化不同手術時機的臨床療效.方法 對比研究瞭49例重癥胸外傷救治的臨床資料,包括治療前後動脈血氣、氧閤指數、基礎生命體徵變化、疼痛程度、手術時間、平均住院日、機械通氣輔助時間、急性呼吸窘迫綜閤徵病死率以及胸片情況.結果 早期手術26例患者全部存活,無一例死亡,胸片改善時間最快治療後第3天,最長第9天效果滿意;晚期手術23例患者1例死亡.兩組患者血氣分析顯示:SAT、PO2、PCO2、PaO2/FiO2在手術後均有顯著改善,與術前比較均有顯著差異.疼痛程度手術後明顯減輕、主動咳嗽增加.結論 創傷性連枷胸患者早期行手術內固定治療,輔以呼吸機輔助呼吸,可大大改善患者的缺氧狀況,減少氣管切開,縮短呼吸機輔助時間,明顯縮短恢複期,併未加重肺損傷和增加病死率.
목적 탐토중증흉외상합병흉벽연화불동수술시궤적림상료효.방법 대비연구료49례중증흉외상구치적림상자료,포괄치료전후동맥혈기、양합지수、기출생명체정변화、동통정도、수술시간、평균주원일、궤계통기보조시간、급성호흡군박종합정병사솔이급흉편정황.결과 조기수술26례환자전부존활,무일례사망,흉편개선시간최쾌치료후제3천,최장제9천효과만의;만기수술23례환자1례사망.량조환자혈기분석현시:SAT、PO2、PCO2、PaO2/FiO2재수술후균유현저개선,여술전비교균유현저차이.동통정도수술후명현감경、주동해수증가.결론 창상성련가흉환자조기행수술내고정치료,보이호흡궤보조호흡,가대대개선환자적결양상황,감소기관절개,축단호흡궤보조시간,명현축단회복기,병미가중폐손상화증가병사솔.
Objective To investigate the relationship between the timing of surgery for severe thoracic trauma combined with softening chest wall and the clinical outcome.Methods We comparatively studied the clinical data of 49 patients (divided into two groups) with severe thoracic trauma before and after surgery,including arterial blood gases,oxygenation index,vital signs,pain degree,time of operation,average length of stay,assisted mechanical ventilation time,fatality rate of ARDS and the status of chest X-ray.Results Twenty-six cases all survived after early operation with satisfied effect of chest X-ray improvement(3-9 days) ; While 1 patient died in 23 cases who received later operation.There was significant difference in SAT,PO2,PCO2,PaO2/FiO2 after surgery (P < O.05).And the pain degree was alleviated obviously,initiated cough increased apparently.Conclusions Patients with traumatic flail chest should receive early operation of internal fixation and assisted mechanical ventilation.It may improve the patient's hypoxia condition,reduce the incision of trachea and lung injury,shorten the assisted mechanical ventilation time and recovery time and cut down the mortality rate.