Potapenkov M A, Shipulin P P, Prokhoda S A
Grud Serdechnososudistaia Khir. 1992(5-6):32-5.
Emergency thoracoscopy was undertaken in 111 patients with complicated closed chest trauma and in 67 persons with penetrating knife wounds of the chest. Thoracoscopy in patients with closed chest trauma revealed pneumohemothorax in 53, pneumothorax in 42, and hemothorax in 10 cases, in 4 patients the hemothorax was coagulated. Penetrating injuries were complicated by pneumohemothorax in 30, by pneumothorax in 21, and by hemothorax in 16 cases. From the results of thoracoscopy, emergency thoracotomy was found to be indicated in 11 patients with penetrating chest wounds. Endoscopic electrocoagulation of the wounds of the lung and thoracic wall was conducted in 28 patients with a closed trauma and in 26 persons with penetrating injuries, laser coagulation was performed in 10 cases with closed trauma and in 8 patient with knife wounds, medical glue was applied for occlusion of surface ruptures of the lung in 11 cases. No complications of thoracoscopy occurred. The therapeutic methods of thoracoscopy with the use of high frequency electric current, NIAH-laser radiation are described. It is concluded that the inclusion of thoracoscopy in the complex of therapeutic and diagnostic measures in patients with complicated chest trauma is expedient.
对111例闭合性胸部复杂创伤患者和67例胸部刀刺伤患者进行了急诊胸腔镜检查。闭合性胸部创伤患者的胸腔镜检查发现53例有血气胸,42例有气胸,10例有血胸,4例血胸已凝固。穿透伤患者中,30例合并血气胸,21例合并气胸,16例合并血胸。根据胸腔镜检查结果,发现11例胸部穿透伤患者需要进行急诊开胸手术。对28例闭合性创伤患者和26例穿透伤患者进行了肺和胸壁伤口的内镜电凝,对10例闭合性创伤患者和8例刀伤患者进行了激光凝固,对11例患者使用医用胶封堵肺表面破裂处。未发生胸腔镜检查并发症。描述了使用高频电流、NIAH激光辐射进行胸腔镜检查的治疗方法。得出结论,将胸腔镜检查纳入复杂胸部创伤患者的治疗和诊断措施中是合适 的。