Bilello John F, Davis James W, Lemaster Deborah M
Department of Surgery, Trauma/Critical Care, University Medical Center, University of California, San Francisco-Fresno Campus, 445 S. Cedar Ave., Fresno, CA 93702, USA.
Am J Surg. 2005 Dec;190(6):841-4. doi: 10.1016/j.amjsurg.2005.05.053.
Size of traumatic occult hemothorax on admission requiring drainage has not been defined. Computed axial tomography (CAT) may guide drainage criteria.
A retrospective review of patients with hemothoraces on CAT was performed. Extrapolating previously described methods of pleural fluid measurement, hemothoraces were quantified using the fluid stripe in the dependent pleural "gutter." Data included patient age, injury severity, and intervention (thoracentesis or tube thoracostomy).
Seventy-eight patients with 99 occult hemothoraces met the criteria for study inclusion: 52 hemothoraces qualified as "minimal" and 47 as "moderate/large." Eight patients (15%) in the minimal group and 31 patients (66%) in the moderate/large group underwent intervention (P < .001). There was no difference in patient age, injury severity, ventilator requirement, or presence of pulmonary contusion.
CAT in stable blunt-trauma patients can predict which patients with occult hemothorax are likely to undergo intervention. Patients with hemothorax > or = 1.5 cm on CAT were 4 times more likely to undergo drainage intervention compared with those having hemothorax < 1.5 cm.
创伤性隐匿性血胸入院时需要引流的大小尚未明确。计算机断层扫描（CAT）可指导引流标准。
对CAT检查发现血胸的患者进行回顾性研究。采用先前描述的测量胸腔积液的方法，通过依赖胸膜“沟”中的液带对血胸进行量化。数据包括患者年龄、损伤严重程度和干预措施（胸腔穿刺术或胸腔闭式引流术）。
78例患者共99处隐匿性血胸符合研究纳入标准：52处血胸为“少量”，47处为“中量/大量”。少量组8例患者（15%）和中量/大量组31例患者（66%）接受了干预（P < 0.001）。患者年龄、损伤严重程度、呼吸机需求或肺挫伤的存在情况无差异。
CAT检查对于稳定的钝性创伤患者，能够预测哪些隐匿性血胸患者可能需要干预。CAT检查显示血胸≥1.5 cm的患者接受引流干预的可能性是血胸<1.5 cm患者的4倍。
Zotero 插件