连枷胸对钝性胸部创伤患者的影响有限——一项配对分析
Limited Influence of Flail Chest in Patients With Blunt Thoracic Trauma - A Matched-pair Analysis.
作者信息
Getz Peter, Mommsen Philipp, Clausen Jan-Dierk, Winkelmann Marcel
机构信息
Trauma Department, Hannover Medical School, Hannover, Germany.
Trauma Department, Hannover Medical School, Hannover, Germany
出版信息
In Vivo. 2019 Jan-Feb;33(1):133-139. doi: 10.21873/invivo.11449.
BACKGROUND
Flail chest is considered as one of the most severe forms of blunt thoracic trauma. However, its actual influence on post-traumatic morbidity and mortality is debatable.
MATERIALS AND METHODS
A retrospective cohort analysis was performed of multiply injured patients (injury severity score ≥16) at a level I trauma center. Flail chest was defined as segment fracture of at least three consecutive ribs on at least one side. Propensity score matching was performed.
RESULTS
A total of 600 patients were included, with a mean age of 44.1±19.1 years and a mean injury severity score of 31.6±10.4. Overall, 367 patients (61.2%) had a serial rib fracture. Forty-five patients (7.5%) presented with flail chest. Patients with flail chest more often had lung contusions (70 vs. 50%, p=0.04) and pneumo-/hematothorax (93 vs. 71%, p=0.005). There were no differences in post-traumatic morbidity and mortality.
CONCLUSION
Flail chest had no independent influence in addition to injury severity on post-traumatic morbidity and mortality in multiply injured patients with blunt thoracic trauma.
背景
连枷胸被认为是钝性胸部创伤最严重的形式之一。然而，其对创伤后发病率和死亡率的实际影响存在争议。
材料与方法
对一级创伤中心的多发伤患者（损伤严重度评分≥16）进行回顾性队列分析。连枷胸定义为至少一侧有至少三根连续肋骨骨折。进行倾向评分匹配。
结果
共纳入600例患者，平均年龄44.1±19.1岁，平均损伤严重度评分为31.6±10.4。总体而言，367例患者（61.2%）有连续肋骨骨折。45例患者（7.5%）出现连枷胸。连枷胸患者更常发生肺挫伤（70%对50%，p=0.04）和气胸/血胸（93%对71%，p=0.005）。创伤后发病率和死亡率无差异。
结论
在钝性胸部创伤的多发伤患者中，除损伤严重度外，连枷胸对创伤后发病率和死亡率无独立影响。
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