Savić B
Acta Chir Iugosl. 1982;29 Suppl 2:103-8.
The mortality rate of chest injuries sustained in road accidents stands now at 15-20 per cent. The considerable force of the impact in road accident is, in 60-80 per cent of the cases responsible for chest injuries which involve other organs. Fractures of a single rib needs only analgetica or intercostal blockade. If a rib is broken in several places or if several rib are fractured instability of the chest wall is act to develop in 15-20 per cent of the cases. It manifest itself in paradoxical breathing and ensuing increase in dead space. In these cases required "internal pneumatic splitting" in form of positive pressure surgical stabilisation of the chest wall has regained favour. Wire or plate osteosynthesis screw-less rib plates and steel splints are being used. Primary stabilisation of the thoracis wall is indicated in the cases: with paradoxical breathing, with respiratory insufficiency or in the cases there are other reasons for thoracotomy. In these circumstances surgical intervention ensure that prolonged artificial ventilation and its attendant risks and complications and the demands made on the nursing staff are reduced to a minimum.
道路交通事故中胸部损伤的死亡率目前为15%至20%。在60%至80%的病例中，道路交通事故中的巨大撞击力是导致胸部损伤并累及其他器官的原因。单根肋骨骨折仅需使用镇痛药或进行肋间阻滞。如果一根肋骨多处骨折或多根肋骨骨折，15%至20%的病例会出现胸壁不稳定。其表现为反常呼吸及随之而来的无效腔增加。在这些情况下，以胸壁正压手术稳定形式进行的“内部气动分离”再次受到青睐。目前正在使用钢丝或钢板骨固定、无螺钉肋骨板和钢夹板。在出现以下情况时，建议对胸壁进行一期稳定：存在反常呼吸、呼吸功能不全或有其他开胸原因的情况。在这些情况下，手术干预可确保将长期人工通气及其伴随的风险和并发症以及对护理人员的要求降至最低。
