Dresing K, Sievers K W, Obertacke U, Reicke B, Schmit-Neuerburg K P
Abteilung für Unfallchirurgie, Universitätsklinikum Essen.
Zentralbl Chir. 1994;119(10):690-701.
In 212 patients after injury of the thorax (54 males, 158 females; penetrating (15), blunt (197), multiple trauma (128)) 158 cases demonstrated rib fractures and 103 radiological proven pneumo- or hematothoraces or sometimes both, 108 of 138 had to be drained. 96.5% of the effusions and 98% of the pneumothoraces were clinical confirmed. 93.5% of 97 pulmonary contusions (79 unilateral, 18 bilateral) were detected by bronchoscopy within 10 h, 72% by x-ray. Caused by anatomical problems or for additional diagnosis 4 patients underwent thoracic CT. During ICU treatment 31 patients developed septic complications without detection in x-ray studies. In CT (n = 64) we found: 5 empyema, 13 pleural effusions, 4 pneumothoraces, 4 pneumocysts, 72 condensations of a lobe. After CT we performed: 9 resections of the lower lobe, 1 pneumectomy, 1 decortication, 7 thoracotomies with drainage, 8 drainages. To detect a septic focus under treatment the CT proved being an important diagnostic tool in chest trauma and lung contusion.
在212例胸部受伤患者中（男性54例，女性158例；穿透伤15例，钝性伤197例，多发伤128例），158例显示有肋骨骨折，103例经放射学证实存在气胸或血胸，有时两者皆有，138例中的108例需要进行引流。96.5%的胸腔积液和98%的气胸经临床证实。97例肺挫伤（79例单侧，18例双侧）中，93.5%在10小时内通过支气管镜检查发现，72%通过X线发现。由于解剖问题或为了进一步诊断，4例患者接受了胸部CT检查。在重症监护病房治疗期间，31例患者出现了感染性并发症，X线检查未发现。在CT检查（n = 64）中，我们发现：5例脓胸，13例胸腔积液，4例气胸，4例肺囊肿，72例肺叶实变。CT检查后，我们进行了：9例下叶切除术，1例肺切除术，1例纤维板剥脱术，7例开胸引流术，8例引流术。对于在治疗过程中发现感染灶，CT被证明是胸部创伤和肺挫伤的重要诊断工具。
