Lunca Sorinel, Morosanu Corneliu, Alexa Ovidiu, Pertea Mihaela
Department of Surgery, University of Medicine and Pharmacology "Gr. T. Popa" Iasi, Emergency Hospital "Sf. Ioan", Iasi, Romania.
Ulus Travma Acil Cerrahi Derg. 2015 Mar;21(2):152-6. doi: 10.5505/tjtes.2015.38354.
Impalement injuries are rare and among the most spectacular and dramatic traumatic lesions. The survival of a patient with a thoracic impalement injury is an extremely rare event. The objective of this study was to present the case of a 24-year-old male patient with a severe thoracic impalement injury successfully treated despite his late arrival in our hospital. A log in 12 cm diameter penetrated his right thorax producing injuries of the right main bronchus, right pulmonary lobe, right subclavian artery as well as extensive parietal lesions. Definitive surgical repair of these lesions was performed more than seven hours after trauma. The management principles contributing to the successful outcome that we would like to emphasize are: rapid transportation and reaction of the trauma team, minimal manipulation of the impaling object, removal of the log as one piece under direct vision in the operating room, ventilatory support, extensive debridement, and lavage associated with appropriate antibiotherapy.
穿刺伤十分罕见，是最惊人且严重的创伤性损伤之一。胸部穿刺伤患者存活的情况极为罕见。本研究的目的是介绍一名24岁男性严重胸部穿刺伤患者的病例，尽管他很晚才被送到我院，但仍成功接受了治疗。一根直径12厘米的原木刺入其右胸，造成右主支气管、右肺叶、右锁骨下动脉损伤以及广泛的胸壁损伤。创伤发生七个多小时后对这些损伤进行了确定性手术修复。我们想强调的促成成功治疗结果的管理原则包括：创伤团队的快速转运与反应、对穿刺物体的最小化操作、在手术室直视下将原木完整取出、通气支持、广泛清创以及与适当抗生素治疗相关的灌洗。
