Braun U, Munz E, Voigt E, Fassolt A
Anaesthesist. 1981 Dec;30(12):595-601.
Respiratory function was investigated in 32 patients not later then 5 years after thoracic trauma. Forced expiration curves (volume/time and flow/volume mode) and nitrogen washout methods (single breath, multiple breath) were used including blood gas analyzes and thorax-X-rays. The typical effect of chest injury is mild to moderate restriction, which was found in 72% of the patients. Usually all volumes (FVC, FRC, TC) are reduced. 5 patients had slight to moderate obstruction, which we do not consider to be immediate consequence of trauma. 12 patients had signs of ventilatory maldistribution, which can be explained by reduced FRC in more or less all cases and obstruction in the above mentioned 5 patients. Observation of two cases leads us to conclude that chest injury may initiate development of chronic respiratory disease and that such a disease may be aggravated by thoracic injury. Motivation, young age, quality of rehabilitation, dorsal location of fractured ribs may help to improve the pulmonary status of the patient, existing or developing chronic lung disease, smoking, old age, lateral localisation of fractured ribs with dislocation will hinder improvement.
对32例胸部创伤后不超过5年的患者进行了呼吸功能研究。采用了用力呼气曲线(容积/时间和流量/容积模式)和氮洗脱法(单次呼吸、多次呼吸),包括血气分析和胸部X光检查。胸部损伤的典型影响是轻度至中度受限,72%的患者存在这种情况。通常所有容积(用力肺活量、功能残气量、肺总量)都会降低。5例患者有轻度至中度阻塞,我们认为这并非创伤的直接后果。12例患者有通气分布不均的体征,在或多或少所有病例中,这可以用功能残气量减少以及上述5例患者存在阻塞来解释。对两例病例的观察使我们得出结论,胸部损伤可能引发慢性呼吸道疾病的发展,并且这种疾病可能因胸部损伤而加重。患者的积极性、年轻、康复质量、肋骨骨折的背部位置可能有助于改善患者的肺部状况,而存在或正在发展的慢性肺部疾病、吸烟、年老、肋骨骨折伴脱位的外侧定位则会阻碍病情改善。