Coman C, Micu V
Rev Chir Oncol Radiol O R L Oftalmol Stomatol Chir. 1979 Jul-Aug;28(4):247-59.
The authors stress the increased frequency in the recent years of single thoracic trauma and of thoracic trauma in the frame of polytraumatic lesions. The fact is stressed that the severity of thoracic trauma is usually determined by pathophysiological syndromes generated sometimes by minor anatomical lesions. An original classification is presented, of thoracic trauma, the present etiopathogenetic concept is discussed, as well as pathophysiologic syndromes consecutive to thoracic trauma. The major types of lesions are illustrated by clinical cases. The treatment of thoracic trauma should respect in the first place the principle of re-equilibration of vital functions that have been disturbed. Only after this has been achieved integrity of the anatomic structures of the organs involved should be attempted. Surgical indications are justified only if the anatomical lesions are the origin of a cardio-respiratory imbalance that cannot be eliminated but by surgical procedures. An original procedure is presented, that of Prof. C. Coman, which achieves immobilization of the flaps with the aid of blades, and the advantages of this system are stressed.
作者强调了近年来单发性胸部创伤以及多发伤中胸部创伤发生率的增加。文中强调了这样一个事实，即胸部创伤的严重程度通常由有时轻微的解剖学损伤所产生的病理生理综合征决定。本文提出了一种胸部创伤的原始分类方法，讨论了当前的病因发病学概念以及胸部创伤后的病理生理综合征。通过临床病例说明了主要的损伤类型。胸部创伤的治疗首先应遵循恢复已受干扰的重要功能平衡的原则。只有在实现这一点之后，才应尝试恢复受累器官解剖结构的完整性。只有当解剖学损伤是导致心肺失衡的根源，且这种失衡无法通过手术以外的方法消除时，手术指征才是合理的。本文介绍了C. 科曼教授的一种原始手术方法，该方法借助刀片实现皮瓣固定，并强调了该系统的优点。
