Klein U, Laubinger R, Malich A, Hapich A, Gunkel W
Klinik für Anaesthesie und operative Intensivtherapie, Südharz-Krankenhaus, Dr. Robert Koch-Strasse 39, 99734 Nordhausen.
Anaesthesist. 2006 Nov;55(11):1172-88. doi: 10.1007/s00101-006-1092-6.
Thoracic trauma, most often associated with other serious injuries, is the main cause of death in the first 45 years of life. The percentage of chest injuries in multiple trauma, mainly from blunt impact, has remained relatively constant at 80% during the last 30 years. Isolated thoracic injuries comprise only 25% of all trauma cases, 90% of chest injuries are due to blunt impact, while penetrating injuries make up 5-10%. Since 25% of deaths from trauma are attributable to chest injuries, they determine the survival rate in multiple trauma to a significant extent. The pattern of chest injuries is variable, frequently in different combinations comprising rib cage and diaphragm, lung parenchyma, airway and mediastinal organs. This article details the immediate simultaneous diagnostic and therapeutic procedures in the prehospital phase, management in the emergency room, the relative importance of computed tomography, ultrasound examination and endoscopy in the primary diagnostic evaluation and the principles of anaesthetic management of thoracic trauma.
胸部创伤通常与其他严重损伤相关，是45岁前主要的死亡原因。在多发伤中，胸部损伤的比例主要来自钝性撞击，在过去30年中一直相对稳定在80%。单纯胸部损伤仅占所有创伤病例的25%，90%的胸部损伤是由钝性撞击所致，而穿透伤占5%-10%。由于25%的创伤死亡归因于胸部损伤，它们在很大程度上决定了多发伤的生存率。胸部损伤的模式多种多样，常见的不同组合包括胸廓和膈肌、肺实质、气道和纵隔器官。本文详细介绍了院前阶段即时同步的诊断和治疗程序、急诊室的处理、计算机断层扫描、超声检查和内镜检查在初步诊断评估中的相对重要性以及胸部创伤麻醉管理的原则。
