Dogrul Bekir Nihat, Kiliccalan Ibrahim, Asci Ekrem Samet, Peker Selim Can
Gulhane Medical School, University of Health Sciences, Ankara, Turkey.
Gulhane Medical School, University of Health Sciences, Ankara, Turkey.
Chin J Traumatol. 2020 Jun;23(3):125-138. doi: 10.1016/j.cjtee.2020.04.003. Epub 2020 Apr 20.
Physical traumas are tragic and multifaceted injuries that suddenly threaten life. Although it is the third most common cause of death in all age groups, one out of four trauma patients die due to thoracic injury or its complications. Blunt injuries constitute the majority of chest trauma. This indicates the importance of chest trauma among all traumas. Blunt chest trauma is usually caused by motor vehicle accident, falling from height, blunt instrument injury and physical assault. As a result of chest trauma, many injuries may occur, such as pulmonary injuries, and these require urgent intervention. Chest wall and pulmonary injuries range from rib fractures to flail chest, pneumothorax to hemothorax and pulmonary contusion to tracheobronchial injuries. Following these injuries, patients may present with a simple dyspnea or even respiratory arrest. For such patient, it is important to understand the treatment logic and to take a multidisciplinary approach to treat the pulmonary and chest wall injuries. This is because only 10% of thoracic trauma patients require surgical operation and the remaining 90% can be treated with simple methods such as appropriate airway, oxygen support, maneuvers, volume support and tube thoracostomy. Adequate pain control in chest trauma is sometimes the most basic and best treatment. With definite diagnosis, the morbidity and mortality can be significantly reduced by simple treatment methods.
身体创伤是突然威胁生命的悲惨且多方面的损伤。尽管它是所有年龄组中第三大常见死因,但四分之一的创伤患者死于胸部损伤或其并发症。钝性损伤构成了胸部创伤的大部分。这表明胸部创伤在所有创伤中的重要性。钝性胸部创伤通常由机动车事故、高处坠落、钝器损伤和人身攻击引起。胸部创伤可能导致多种损伤,如肺部损伤,这些都需要紧急干预。胸壁和肺部损伤范围从肋骨骨折到连枷胸、气胸到血胸以及肺挫伤至气管支气管损伤。这些损伤后,患者可能表现为单纯的呼吸困难甚至呼吸骤停。对于此类患者,了解治疗逻辑并采取多学科方法治疗肺部和胸壁损伤非常重要。这是因为只有10%的胸部创伤患者需要手术治疗,其余90%可以通过适当的气道、氧气支持、手法、容量支持和胸腔闭式引流等简单方法进行治疗。胸部创伤中充分的疼痛控制有时是最基本也是最好的治疗方法。明确诊断后,通过简单的治疗方法可显著降低发病率和死亡率。