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[钝性胸部创伤中影响死亡率的因素]

[Factors affecting mortality in blunt thoracic trauma].

作者信息

Hasbahçeci Mustafa, Ozpek Adnan, Başak Fatih, Calışkan Müjgan, Ener Behçet Kemal, Alimoğlu Orhan

机构信息

Department of General Surgery, Ümraniye Training and Research Hospital, İstanbul, Turkey.

出版信息

Ulus Travma Acil Cerrahi Derg. 2013 Mar;19(2):127-32. doi: 10.5505/tjtes.2013.54782.

Abstract

BACKGROUND

Blunt thoracic trauma is usually associated with extra-thoracic injuries, but the effect of blunt thoracic trauma on mortality is not known.

METHODS

Patients with blunt thoracic trauma were evaluated with regard to clinical findings and factors affecting mortality.

RESULTS

There were 76 patients (37.2±15 years) in the study group. Traffic accidents (63%) were the most common cause of trauma. Pneumothorax (54%), rib fracture (42%), hemothorax (22%) and lung contusion (22%) were common thoracic injuries. Extra-thoracic injuries were most commonly seen in the extremities (46%) and abdomen (40%). Glasgow Coma, Injury Severity and Revised Trauma Scores were 14±2.6, 19±13 and 7.4±1.5, respectively. Non-operative management was effective in 37 (48.7%) patients, tube thoracotomy and thoracotomy were performed in 37 (48.7%) and 2 (2.6%) patients, respectively. Mortality rate was 10.5%. Systolic blood pressure lower than 90 mmHg and superficial and apneic respiration at the first admission, and values of trauma scoring systems were significantly associated with mortality (p<0.05).

CONCLUSION

The effect of thoracic trauma on mortality with regard to thoracic pathology is not shown, although it is usually associated with extra-thoracic injuries. There was a close relationship between the pattern of respiration, values of systolic blood pressure and trauma scoring systems, and mortality. Non-operative management and tube thoracotomy were effective in most of the cases.

摘要

背景

钝性胸部创伤通常与胸外损伤相关,但钝性胸部创伤对死亡率的影响尚不清楚。

方法

对钝性胸部创伤患者的临床表现及影响死亡率的因素进行评估。

结果

研究组有76例患者(37.2±15岁)。交通事故(63%)是最常见的创伤原因。气胸(54%)、肋骨骨折(42%)、血胸(22%)和肺挫伤(22%)是常见的胸部损伤。胸外损伤最常见于四肢(46%)和腹部(40%)。格拉斯哥昏迷评分、损伤严重度评分和改良创伤评分分别为14±2.6、19±13和7.4±1.5。37例(48.7%)患者非手术治疗有效,37例(48.7%)患者行胸腔闭式引流术,2例(2.6%)患者行开胸手术。死亡率为10.5%。首次入院时收缩压低于90 mmHg、浅表呼吸和呼吸暂停以及创伤评分系统的值与死亡率显著相关(p<0.05)。

结论

尽管钝性胸部创伤通常与胸外损伤相关,但未显示出胸部创伤对胸部病理状况下死亡率的影响。呼吸模式、收缩压值和创伤评分系统与死亡率之间存在密切关系。大多数病例中非手术治疗和胸腔闭式引流术有效。

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