Kaiser D, Stuber U, Fischer D
Prax Klin Pneumol. 1979 Apr;33 Suppl 1:507-10.
Deformation of the chest wall and pleural adhesions are some of the sequelae of chest trauma with fractures of ribs. If sufficiently extensive these lesions may result in restrictive disturbances of ventilation and partial respiratory insufficiency. In these cases marked improvement in function and perfusion can be obtained by decortication at an early stage. Follow-up examinations of 37 patients who had sustained fractures of more than 4 ribs revealed restrictive respiratory impairment in only three cases. Hypoxia was present in 11, but a causal connection with the trauma could be ascertained in only 4 persons. For assessing the extent of the lesions and the indications for decortication perfusion scanning is a "must", as it will show up pathological changes at a time when the gaseous exchange and lung function still appear normal. There seems to be no correlation between the radiological extent of the adhesions or the deformation of the thorax and the extent of changes in lung function and blood gases.
胸壁变形和胸膜粘连是肋骨骨折所致胸部创伤的一些后遗症。如果这些病变足够广泛，可能会导致通气受限和部分呼吸功能不全。在这些情况下，早期行胸膜剥脱术可使功能和灌注得到显著改善。对37例肋骨骨折超过4根的患者进行随访检查发现，仅有3例存在限制性呼吸功能损害。11例存在低氧血症，但仅4人可确定与创伤有因果关系。为了评估病变程度和胸膜剥脱术的指征，灌注扫描是“必需的”，因为在气体交换和肺功能仍看似正常时，它就能显示出病理变化。胸膜粘连的放射学范围或胸廓变形与肺功能和血气变化程度之间似乎没有相关性。
