胸部刺伤：100例连续病例的回顾性研究
Stab wounds to the chest: a retrospective review of 100 consecutive cases.
作者信息
Fullum T M, Siram S M, Righini M
机构信息
Department of Surgery, Howard University Hospital, Washington, DC 20060.
出版信息
J Natl Med Assoc. 1990 Feb;82(2):109-12.
In a retrospective review of 100 consecutive cases of stab wounds to the chest, 44 patients were successfully treated with tube thoracostomy, 14 patients required thoracotomy, 17 patients with small pneumothoraces were observed, and 25 patients were asymptomatic. The overall mortality was 4%, operative mortality was 7.1%, and the mortality rate for cardiac injuries was 50%. Of the eight patients with cardiac injuries, three were dead on arrival to the hospital and one patient died in the operating room. Patients treated with tube thoracostomy had a shorter hospital stay than patients managed by observation alone. Our findings support the opinion that asymptomatic patients (normal chest x-rays) may be discharged after 24 hours of observation and asymptomatic patients with nonprogressive small pneumothoraces (less than 20%) not requiring a chest tube may be discharged after 48 hours of observation. All patients should have close outpatient follow-up.
在一项对连续100例胸部刺伤病例的回顾性研究中，44例患者通过胸腔闭式引流术成功治疗，14例患者需要开胸手术，17例小气胸患者接受观察，25例患者无症状。总死亡率为4%，手术死亡率为7.1%，心脏损伤的死亡率为50%。在8例心脏损伤患者中，3例在到达医院时死亡，1例在手术室死亡。接受胸腔闭式引流术治疗的患者住院时间比仅接受观察的患者短。我们的研究结果支持以下观点：无症状患者（胸部X光正常）在观察24小时后可出院，无症状且小气胸无进展（小于20%）且不需要胸腔引流管的患者在观察48小时后可出院。所有患者都应进行密切的门诊随访。
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