Round J A, Mellor A J
Friarage Hospital, Northallerton.
J R Army Med Corps. 2010 Sep;156(3):145-9. doi: 10.1136/jramc-156-03-03.
Thoracic wounding has been a relatively common presentation of military wounds throughout modern conflict. When civilian casualties are included the incidence has remained constant at around 10%, although the frequency and severity of wounds to combatants has been altered by modern body armour. Whilst thoracic injury has a high initial mortality on the battlefield, those surviving to reach hospital frequently have injuries that only require simple management. In addition to penetrating ballistic injury, blunt chest trauma frequently occurs on operations as a result of road traffic collisions or tertiary blast injury. The physiological impact of thoracic wounds, however, is often great and survivors often require intensive care management and, where available, complex strategies to ensure oxygenation and carbon dioxide removal. This review examines the incidence and patterns of thoracic trauma and looks at therapeutic options for managing these complex cases.
在整个现代冲突中，胸部创伤一直是军事创伤中较为常见的表现形式。若将平民伤亡也算在内，其发生率一直保持在10%左右，尽管现代防弹衣改变了战斗人员受伤的频率和严重程度。虽然胸部损伤在战场上的初始死亡率很高，但那些存活下来并被送往医院的伤员，其伤势往往只需简单处理。除了穿透性弹道伤外，钝性胸部创伤在行动中也经常因道路交通事故或三级爆炸伤而发生。然而，胸部创伤对生理的影响通常很大，幸存者往往需要重症监护管理，并且在可行的情况下，需要采用复杂的策略来确保氧合和二氧化碳排出。本综述探讨了胸部创伤的发生率和模式，并研究了处理这些复杂病例的治疗选择。
