Rendeki Szilárd, Molnár Tamás F
Department of Anaesthesiology and Intensive Therapy, University of Pécs Medical School, Pécs, Hungary.
Department of Operational Medicine, Faculty of Medicine, University of Pécs, Medical School University of Pécs, Pécs, Hungary.
J Thorac Dis. 2019 Feb;11(Suppl 2):S141-S151. doi: 10.21037/jtd.2018.11.53.
Lung contusion resulting from chest trauma may be present various clinical pictures. It quite often remains unrecognized and is only suspected later when severe complications have developed. Lung contusion may present in association with chest trauma but may also occur alone. It has to be emphasized, that lung contusion as a clinical identity does not necessarily require a blunt or penetrating chest to be in the background. Nowadays, as a result of traffic accidents, following high energy deceleration, lung contusion may present without an actual tissue damage in the chest wall as a condition initiating an independent, life-threatening generalised process. Although lung contusion shows similarities to blast injury of the lung with respect to clinical consequences, other factors play a role in its aetiology and pathology. Its description and recognition as an independent pathology is not simple. Several approaches exist: thoracic trauma, pulmonary contusion, pulmonary laceration, lung contusion; although these may show similar clinical signs, manifest in different pathologies. Pathologies with similar meaning and possibly similar clinical course cannot, actually, be differentiated; they may accompany other injuries to the trunk, skull or extremities, which, alone, are associated with high morbidity and mortality. Generally, it can be declared that besides high energy, blunt injuries affecting the trunk, lung contusion, has been an often neglected additional radiological finding attached to the main report, despite the fact, that its late consequences crucially determine the prospects of the injured.
胸部创伤导致的肺挫伤可能呈现出各种临床表现。它常常未被识别,只有在严重并发症出现后才会被怀疑。肺挫伤可能与胸部创伤同时出现,但也可能单独发生。必须强调的是,作为一种临床病症,肺挫伤并不一定需要钝性或穿透性胸部创伤作为背景。如今,由于交通事故,在高能量减速后,肺挫伤可能在胸壁没有实际组织损伤的情况下出现,作为引发一个独立的、危及生命的全身性过程的病症。尽管肺挫伤在临床后果方面与肺爆震伤相似,但其病因和病理涉及其他因素。将其描述和识别为一种独立的病理并不简单。存在多种表述方式:胸部创伤、肺挫伤、肺撕裂伤、肺挫裂伤;尽管它们可能表现出相似的临床体征,但病理情况不同。实际上,具有相似含义且可能临床病程相似的病症无法区分;它们可能伴有躯干、颅骨或四肢的其他损伤,而这些损伤本身就与高发病率和死亡率相关。一般来说,可以宣称,除了影响躯干的高能量钝性损伤外,肺挫伤一直是主要报告中经常被忽视的额外影像学发现,尽管事实上,其后期后果对伤者的预后起着关键作用。