Emergency and Critical Care Center, The Fourth Affiliated Hospital of Nantong University, Yancheng, China.
Department of Thoracic and Cardiovascular Surgery, The Fourth Affiliated Hospital of Nantong University, Yancheng, China.
Prehosp Disaster Med. 2020 Jun;35(3):335-340. doi: 10.1017/S1049023X20000345. Epub 2020 Mar 23.
The aim of this study was to analyze the profile of chest injuries, oxygen therapy for respiratory failure, and the outcomes of victims after the Jiangsu tornado, which occurred on June 23, 2016 in Yancheng City, Jiangsu Province, China.
The clinical records of 144 patients referred to Yancheng City No.1 People's Hospital from June 23 through June 25 were retrospectively investigated. Of those patients, 68 (47.2%) sustained major chest injuries. The demographic details, trauma history, details of injuries and Abbreviated Injury Scores (AIS), therapy for respiratory failure, surgical procedures, length of intensive care unit (ICU) and hospital stay, and mortality were analyzed.
Of the 68 patients, 41 (60.3%) were female and 27 (39.7%) were male. The average age of the injured patients was 57.1 years. Forty-six patients (67.6%) suffered from polytrauma. The mean thoracic AIS of the victims was calculated as 2.85 (SD = 0.76). Rib fracture was the most common chest injury, noted in 56 patients (82.4%). Pulmonary contusion was the next most frequent injury, occurring in 12 patients (17.7%). Ten patients with severe chest trauma were admitted to ICU. The median ICU stay was 11.7 (SD = 8.5) days. Five patients required intubation and ventilation, one patient was treated with noninvasive positive pressure ventilation (NPPV), and four patients were treated with high-flow nasal cannula (HFNC). Three patients died during hospitalization. The hospital mortality was 4.41%.
Chest trauma was a common type of injury after tornado. The most frequent thoracic injuries were rib fractures and pulmonary contusion. Severe chest trauma is usually associated with a high incidence of respiratory support requirements and a long length of stay in the ICU. Early initiation of appropriate oxygen therapy was vital to restoring normal respiratory function and saving lives. Going forward, HFNC might be an effective and well-tolerated therapeutic addition to the management of acute respiratory failure in chest trauma.
本研究旨在分析 2016 年 6 月 23 日江苏省盐城市龙卷风中胸部损伤、呼吸衰竭氧疗以及患者预后的特点。
回顾性调查了 2016 年 6 月 23 日至 25 日期间被送往盐城市第一人民医院的 144 例患者的临床记录。其中 68 例（47.2%）患者存在严重胸部损伤。分析了这些患者的人口统计学细节、创伤史、损伤细节和损伤严重程度评分（AIS）、呼吸衰竭治疗、手术过程、重症监护病房（ICU）和住院时间以及死亡率。
68 例患者中，41 例（60.3%）为女性，27 例（39.7%）为男性。受伤患者的平均年龄为 57.1 岁。46 例（67.6%）患者为多发伤。患者的平均胸部 AIS 为 2.85（SD=0.76）。肋骨骨折是最常见的胸部损伤，56 例（82.4%）患者存在肋骨骨折。其次最常见的损伤是肺挫伤，12 例（17.7%）患者存在肺挫伤。10 例严重胸部创伤患者被收入 ICU。ICU 中位住院时间为 11.7（SD=8.5）天。5 例患者需要插管和通气，1 例患者接受无创正压通气（NPPV）治疗，4 例患者接受高流量鼻导管（HFNC）治疗。3 例患者在住院期间死亡。医院死亡率为 4.41%。
胸部创伤是龙卷风后常见的损伤类型。最常见的胸部损伤是肋骨骨折和肺挫伤。严重的胸部创伤通常与较高的呼吸支持需求和较长的 ICU 住院时间相关。早期开始适当的氧疗对于恢复正常呼吸功能和挽救生命至关重要。未来，HFNC 可能是治疗胸部创伤急性呼吸衰竭的一种有效且耐受良好的治疗方法。
