Cansever Levent, Hacıibrahimoğlu Gökhan, Kutlu Cemal Asım, Bedirhan Mehmet Ali
Yedikule Chest Diseases and Chest Surgery Research and Teaching Hospital, 3. Clinics of Surgery, Istanbul, Turkey.
Ulus Travma Acil Cerrahi Derg. 2005 Oct;11(4):306-9.
The aim of this study was to evaluate the systematic approach to the isolated traumatic hemothorax.
The treatment modalities of 103 cases with isolated hemothorax was analyzed retrospectively between 1995 and 2003.
We observed 103 isolated hemothorax cases. Eighty eight of them were male and 15 were female. The mean age was 39.4 years. The hemothorax was left sided at 41 cases, right sided at 60 cases and bilateral at 2 cases. Fifty three (51,4%) penetrating, forty nine (47,5%) blunt, and one (0,9%) iatrogenic traumas with resultant hemothoraxes were investigated. We performed tube thoracostomy in ninety nine cases. One case required an urgent thoracotomy. We operated twenty one cases and thoracoscopy was performed for six of them. The conservative approach was sufficient for eighty two patients. Mortality was seen in only one case (0,9%), because of a multiorgan failure. The mean rate of the hospital stay was 8,7 days. During operation, we explored for major pulmonary and systemic artery injury.
The decision of exploration or conservative treatment must be made according to the patient stabilization status after the thoracostomy tube insertion. Thoracoscopic evacuation of blood clots from hemothoraxes must be attempted during the early posttraumatic stages, especially in cases refractory to classical drainage methods.
本研究旨在评估对单纯性创伤性血胸的系统治疗方法。
回顾性分析1995年至2003年间103例单纯性血胸患者的治疗方式。
我们观察了103例单纯性血胸病例。其中男性88例，女性15例。平均年龄为39.4岁。血胸发生在左侧41例，右侧60例，双侧2例。研究了53例（51.4%）穿透性、49例（47.5%）钝性和1例（0.9%）医源性创伤导致的血胸。我们对99例患者进行了胸腔闭式引流术。1例需要紧急开胸手术。我们对21例患者进行了手术，其中6例进行了胸腔镜检查。82例患者采用保守治疗方法即可。仅1例（0.9%）因多器官功能衰竭死亡。平均住院时间为8.7天。手术期间，我们探查了主要的肺部和体动脉损伤。
胸腔闭式引流管插入后，必须根据患者的稳定状态决定是否进行探查或保守治疗。在创伤后早期，尤其是对传统引流方法无效的病例，必须尝试通过胸腔镜清除血胸中的血凝块。
