Majercik Sarah, Pieracci Fredric M
Division of Trauma and Surgical Critical Care, Intermountain Medical Center, 5121 South Cottonwood Street, Murray, UT 84107, USA.
Department of Surgery, Denver Health Medical Center, University of Colorado School of Medicine, 777 Bannock Street, MC0206, Denver, CO 80204, USA.
Thorac Surg Clin. 2017 May;27(2):113-121. doi: 10.1016/j.thorsurg.2017.01.004.
Chest wall trauma is common, and contributes significantly to morbidity and mortality of trauma patients. Early identification of major chest wall and concomitant intrathoracic injuries is critical. Generalized management of multiple rib fractures and flail chest consists of adequate pain control (including locoregional modalities); management of pulmonary dysfunction by invasive and noninvasive means; and, in some cases, surgical fixation. Multiple studies have shown that patients with flail chest have substantial benefit (decreased ventilator and intensive care unit days, improved pulmonary function, and improved long-term functional outcome) when they undergo surgery compared with nonoperative management.
胸壁创伤很常见，对创伤患者的发病率和死亡率有重大影响。早期识别主要胸壁损伤及伴发的胸内损伤至关重要。多根肋骨骨折和连枷胸的综合治疗包括充分的疼痛控制（包括局部治疗方式）；通过有创和无创手段处理肺功能障碍；以及在某些情况下进行手术固定。多项研究表明，与非手术治疗相比，连枷胸患者接受手术治疗有显著益处（减少呼吸机使用天数和重症监护病房住院天数、改善肺功能以及改善长期功能结局）。
