Ilić N, Petricević A, Tanfara S, Mimica Z, Radonić V, Tripković A, Frleta Ilić N
University Surgical Hospital, Split, Croatia.
Acta Chir Hung. 1999;38(1):43-7.
Presentation of our experiences in the treatment of war injuries to the chest at the Split University Hospital, Croatia, during the 1991-1995 war in Croatia and Bosnia-Hercegovina.
Retrospective analysis of clinical and surgical data on 439 (16.3%) patients with war injuries to the chest among 2693 treated battle casualties in general. The medical data from evacuation unit, transportation, emergency department and follow-up were observed and processed by basic statistical analysis.
There were more explosive wounds than gunshot and puncture wounds (ratio 251/158/30). Penetrating injuries were found in 348 (79%) patients and nonpenetrating in 91 (21%) patients. There were 401 (91%) men and 38 (9%) women. Thoracotomy was performed in 98 (22.3%) patients, whereas conservative surgical methods (wound treatment, chest-tube drainage, appropriate fluid therapy, antimicrobial and atelectasis prophylaxis) were used in 341 (77.7%) patients. Mean time elapsed between injury and definitive surgical repair was seven hours (range, 1 to 48 hours). Recovery on discharge was recorded in 411 (93.6%) patients, 19 (4.3%) patients were referred to other institution for further treatment, and 9 (2%) severely wounded persons died.
The treatment of respiratory insufficiency and haemorrhage shock, and prevention of infection are the basis of management of these injuries. Prompt transportation, appropriate diagnostic methods and an adequate surgical treatment can markedly reduce mortality and complications rate in war injuries to the chest. Most war wound of the lung can be successfully managed by "conservative" surgical treatment. The recovery of lung function was similar in conservatively and operatively treated patients.
介绍1991 - 1995年克罗地亚和波斯尼亚 - 黑塞哥维那战争期间，克罗地亚斯普利特大学医院治疗胸部战争伤的经验。
对2693例战伤伤员中439例（16.3%）胸部战争伤患者的临床和手术数据进行回顾性分析。观察并通过基本统计分析处理来自疏散单位、运输、急诊科及随访的医疗数据。
爆炸伤多于枪伤和刺伤（比例为251/158/30）。348例（79%）患者为穿透伤，91例（21%）患者为非穿透伤。男性401例（91%），女性38例（9%）。98例（22.3%）患者接受了开胸手术，而341例（77.7%）患者采用了保守手术方法（伤口处理、胸腔闭式引流、适当的液体治疗、抗菌及预防肺不张）。受伤至确定性手术修复的平均时间为7小时（范围1至48小时）。411例（93.6%）患者出院时康复，19例（4.3%）患者转至其他机构进一步治疗，9例（2%）重伤患者死亡。
治疗呼吸功能不全和失血性休克以及预防感染是这些损伤治疗的基础。及时运输、适当的诊断方法和充分的手术治疗可显著降低胸部战争伤的死亡率和并发症发生率。大多数肺部战争伤可通过“保守”手术治疗成功处理。保守治疗和手术治疗患者的肺功能恢复情况相似。
