闭合性胸部损伤87例报告

本文分析87例闭合性胸部损伤的临床资料。提出心肌挫伤可能是胸伤后休克的主要原因之一。心肌挫伤的症状和防治与心肌梗塞的相似。对于肋骨骨折的处理,止痛是主要的,而胸璧固定并非完全必要。同意肺挫伤是造成外伤性连枷胸时呼吸窘迫、低氧血症的重要原因的理论,而胸璧软化下反常呼吸并不能完全解释其伤后病理生理的变化,所以在处理上应针对肺挫伤所引起的病理生理改变而制定合理的治疗方案,包括:迅速解除呼吸道的机械性阻塞或呼吸压迫,以血气分析为指标纠正呼吸通气功能,有效的止痛,早期限制液体量和给予抗生素治疗。本组两例连枷胸病人,基本采用上述方案治疗,获得满意疗效。

REPORT OF 87 CASES OF CLOSED CHEST INJURY

The clinical data of 87 cases of closed chest injury have been analysed. The paper proposes that myocardial contusion is probably one of the cardinal causes of shock after injury. The symptoms and management of myocardial contusion are somewhat similar to those of angina pectoris. Analgesia plays an important position in the treatment of rib fractures, and the stabilization of chest wall is not necessary, it is only applied to some selected cases. The paper agrees with the theory that pulmonary contusion is an important cause of respiratory distress and hypoxemia after traumatic flail chest, and the paradoxical respiration from the softened chest wall cannot completely explain the development of pathophysiological changes. The plan of rational treatment should be formulated in accordance with the pathophysiological changes caused by pulmonary contusion, including promptly relieve of mechanical obstruction of the respiratory tract or respiratory compression, correction of respiratory ventilative function by the indications of gas analysis, effective analgesia, limitation of fluid retake in the early stage and administration of antibiotic drugs. Two cases were treated fundamentally by the method as mentioned above, and good result is achieved.