Mohan Pvr, Mohan R
Associate Professor, Department of Surgery, Armed Forces Medical College, Pune-40.
Clinical Tutor, Department of Surgery, Armed Forces Medical College, Pune-40.
Med J Armed Forces India. 2010 Oct;66(4):329-32. doi: 10.1016/S0377-1237(10)80010-3. Epub 2011 Jul 21.
About 15 % of war injuries involve the chest. Fortunately 85% of patients sustaining chest injuries that reach medical facility will require clinical observation or a simple procedure like tube thoracostomy. Only one in six patients has life-threatening injuries that necessitate urgent operative repair. Early deaths are caused by airway obstruction, major respiratory problems such as tension pneumothorax or massive hemothorax, and cardiac tamponade. These conditions are easily managed if recognized promptly. Diagnosis and management of various components of chest injury requires clear judgment and indepth knowledge of pathophysiological mechanisms involved. The therapeutic goal in the war scenario is to restore normal physiology and thereby to restore cardiac and pulmonary function and evacuate the patient after stabilization.
约15%的战争伤涉及胸部。幸运的是,85%胸部受伤并送达医疗机构的患者仅需要临床观察或进行诸如胸腔闭式引流术等简单操作。每六名患者中只有一名有危及生命的损伤,需要紧急手术修复。早期死亡原因包括气道阻塞、严重呼吸问题(如张力性气胸或大量血胸)和心脏压塞。如果能及时识别,这些情况很容易处理。胸部损伤各个组成部分的诊断和处理需要清晰的判断以及对相关病理生理机制的深入了解。战争情况下的治疗目标是恢复正常生理功能,从而恢复心肺功能,并在病情稳定后将患者后送。