Bastos Renata, Baisden Clinton E, Harker Lori, Calhoon John H
Division of Cardiothoracic Surgery, University of Texas Health Science Center at San Antonio, San Antonio, TX 78229-3900, USA.
Semin Thorac Cardiovasc Surg. 2008 Spring;20(1):19-25. doi: 10.1053/j.semtcvs.2008.01.003.
The initial approach to penetrating thoracic trauma is directed towards the pathophysiologic syndrome upon presentation. Most patients are successfully treated with drainage tubes. The unstable patient may necessitate thoracotomy at the emergency room to drain cardiac tamponade, provide cardiac massage and control bleeding. The guidelines for this procedure are reviewed. Need for further work-up of potential injuries to other mediastinal organs is frequently screened by computerized tomography. Surgery might still be needed, on a less emergent basis, in order to repair injuries to the trachea/esophagus, retained hemothorax, or to rule out diaphragmatic injury. Laparoscopic and thoracoscopic procedures may be used in specific situations.
穿透性胸部创伤的初始治疗方法针对就诊时的病理生理综合征。大多数患者通过引流管治疗成功。不稳定的患者可能需要在急诊室进行开胸手术，以引流心脏压塞、进行心脏按摩并控制出血。本文回顾了该手术的指南。计算机断层扫描经常用于筛查是否需要进一步检查其他纵隔器官的潜在损伤。在不太紧急的情况下，可能仍需要手术来修复气管/食管损伤、清除残留血胸或排除膈肌损伤。腹腔镜和胸腔镜手术可用于特定情况。
