多发伤性胸外伤在四川特大地震中的评估:215 例多排 CT 分析

Crush thoracic trauma in the massive Sichuan earthquake: evaluation with multidetector CT of 215 cases.

机构信息

Department of Radiology, West China Hospital of Sichuan University, 37 Guo Xue Xiang, Chengdu, Sichuan 610041, China.

出版信息

Radiology. 2010 Jan;254(1):285-91. doi: 10.1148/radiol.09090685. Epub 2009 Dec 17.

Abstract

PURPOSE

To determine the multidetector computed tomographic (CT) features of crush thoracic traumas resulting from the massive Sichuan earthquake.

MATERIALS AND METHODS

This study was approved by the ethics committee of the medical school, and informed consent was waived. A retrospective review was undertaken of 215 multidetector chest CT scans of 112 male and 103 female patients who sustained crush thoracic injuries in the Sichuan earthquake at 2:28 pm Beijing time, May 12, 2008, and were rescued in the authors' hospital. Multidetector chest CT studies were performed between May 12, 2008, and June 7, 2008. The authors looked for injuries to the thoracic cage, pulmonary parenchyma, and pleura.

RESULTS

One hundred forty-three patients (66.5%; 95% confidence interval [CI]: 60.2%, 72.8%) had at least one rib fracture; the mean number of rib fractures per patient was 6 [corrected]. Forty-five of these patients (31.5% of 143 patients; 95% CI: 23.9%, 39.1%) had flail chest, with a total of 288 ribs fractured. There were 46 patients (21.4%; 95% CI: 15.9%, 26.9%) with at least one vertebral fracture. There were 77 vertebral fractures total; 36 of these fractures were in T1 through T10. Twelve patients (5.6%; 95% CI: 2.5%, 8.7%) had sternal fractures, and 48 patients (22.3%; 95% CI: 16.7%, 27.9%) had either scapular or clavicular fractures. There were 117 patients (54.4%; 95% CI: 47.7%, 61.1%) with pulmonary parenchymal injuries and 146 (67.9%; 95% CI: 61.7%, 74.1%) with pleural injuries.

CONCLUSION

Crush thoracic trauma resulting from the massive Sichuan earthquake was a life-threatening injury; this type of injury has the potential for multiple fractures and pulmonary parenchymal injuries.

摘要

目的

确定 2008 年 5 月 12 日下午 2 点 28 分四川地震中大量发生的挤压性胸部创伤的多层螺旋 CT 特征。

材料与方法

本研究经医学院伦理委员会批准,并放弃了知情同意。回顾性分析了 2008 年 5 月 12 日至 6 月 7 日期间在作者医院接受救治的 112 名男性和 103 名女性挤压性胸部创伤患者的 215 例多层胸部 CT 扫描。研究人员寻找胸壁、肺实质和胸膜的损伤。

结果

143 例患者(66.5%;95%置信区间[CI]:60.2%,72.8%)至少有 1 处肋骨骨折;每位患者的平均肋骨骨折数为 6 处。其中 45 例患者(143 例患者中的 31.5%;95%CI:23.9%,39.1%)为连枷胸,共 288 根肋骨骨折。46 例患者(21.4%;95%CI:15.9%,26.9%)至少有 1 处椎体骨折。共发生 77 处椎体骨折,其中 36 处位于 T1-T10。12 例患者(5.6%;95%CI:2.5%,8.7%)有胸骨骨折,48 例患者(22.3%;95%CI:16.7%,27.9%)有肩胛骨或锁骨骨折。117 例患者(54.4%;95%CI:47.7%,61.1%)有肺实质损伤,146 例患者(67.9%;95%CI:61.7%,74.1%)有胸膜损伤。

结论

四川地震导致的挤压性胸部创伤是一种危及生命的损伤;这种类型的损伤有可能导致多处骨折和肺实质损伤。

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