Department of Surgery, University of Texas Health Sciences Center, 7703 Floyd Curl Drive, San Antonio, TX 78229, USA.
World J Surg. 2010 Aug;34(8):1959-70. doi: 10.1007/s00268-010-0599-9.
Pulmonary contusion is a common finding after blunt chest trauma. The physiologic consequences of alveolar hemorrhage and pulmonary parenchymal destruction typically manifest themselves within hours of injury and usually resolve within approximately 7 days. Clinical symptoms, including respiratory distress with hypoxemia and hypercarbia, peak at about 72 h after injury. The timely diagnosis of pulmonary contusion requires a high degree of clinical suspicion when a patient presents with trauma caused by an appropriate mechanism of injury. The clinical diagnosis of acute parenchymal lung injury is usually confirmed by thoracic computed tomography, which is both highly sensitive in identifying pulmonary contusion and highly predictive of the need for subsequent mechanical ventilation. Management of pulmonary contusion is primarily supportive. Associated complications such as pneumonia, acute respiratory distress syndrome, and long-term pulmonary disability, however, are frequent sequelae of these injuries.
肺挫伤是钝性胸部创伤后的常见表现。肺泡出血和肺实质破坏的生理后果通常在损伤后数小时内表现出来，通常在大约 7 天内消退。临床症状，包括伴有低氧血症和高碳酸血症的呼吸窘迫，在损伤后约 72 小时达到高峰。当患者因适当的损伤机制导致创伤时，需要高度的临床怀疑才能及时诊断肺挫伤。急性实质肺损伤的临床诊断通常通过胸部计算机断层扫描确认，该扫描在识别肺挫伤方面具有高度敏感性，并高度预测随后需要机械通气。肺挫伤的治疗主要是支持性的。然而，肺炎、急性呼吸窘迫综合征和长期肺功能障碍等相关并发症是这些损伤的常见后遗症。
