Massarutti Daniele, Trillò Giulio, Berlot Giorgio, Tomasini Ariella, Bacer Barbara, D'Orlando Loris, Viviani Marino, Rinaldi Adriano, Babuin Alberto, Burato Lorenzo, Carchietti Elio
Helicopter Emergency Medical Service Friuli-Venezia Giulia, Udine Hospital, Udine, Italy.
Eur J Emerg Med. 2006 Oct;13(5):276-80. doi: 10.1097/00063110-200610000-00006.
To evaluate the effectiveness and potential complications of simple thoracostomy, as first described by Deakin, as a method for prehospital treatment of traumatic pneumothorax.
Prospective observational study of all severe trauma patients rescued by our Regional Helicopter Emergency Medical Service and treated with on-scene simple thoracostomy, over a period of 25 months, from June 1, 2002 to June 30, 2004.
Fifty-five consecutive severely injured patients with suspected pneumothorax and an average Revised Trauma Score of 9.6+/-2.7 underwent field simple thoracostomy. Oxygen saturation significantly improved after the procedure (from 86.4+/-10.2% to 98.5%+/-4.7%, P<0.05). No difference exists in the severity of thoracic lesions between patients with systolic arterial pressure and oxygen saturation below and above or equal to 90. A pneumothorax or a haemopneumothorax was found in 91.5% of the cases and a haemothorax in 5.1%. No cases of major bleeding, lung laceration or pleural infection were recorded. No cases of recurrent tension pneumothorax were observed. Forty (72.7%) patients survived to hospital discharge.
Prehospital treatment of traumatic pneumothorax by simple thoracostomy without chest tube insertion is a safe and effective technique.
评估由迪肯首次描述的简易胸腔造口术作为创伤性气胸院前治疗方法的有效性和潜在并发症。
对2002年6月1日至2004年6月30日期间，由我们地区直升机紧急医疗服务机构救治并在现场接受简易胸腔造口术治疗的所有严重创伤患者进行前瞻性观察研究，为期25个月。
55例连续的疑似气胸且平均修正创伤评分9.6±2.7的重伤患者接受了现场简易胸腔造口术。术后氧饱和度显著改善（从86.4±10.2%升至98.5%±4.7%，P<0.05）。收缩压和氧饱和度低于及高于或等于90的患者之间，胸部损伤严重程度无差异。91.5% 的病例发现气胸或血气胸，5.1% 发现血胸。未记录到大出血、肺裂伤或胸膜感染病例。未观察到复发性张力性气胸病例。40例（72.7%）患者存活至出院。
不插入胸管的简易胸腔造口术进行创伤性气胸的院前治疗是一种安全有效的技术。
