Wilhelm T, Zieren H U, Müller J M, Pichlmaier H
Centre Hospitalier Universitaire de Cologne.
Ann Chir. 1993;47(5):426-32.
With intensive care, pleural drainage and judicious physiotherapy most thoracic injuries can be treated adequately. 571 patients were treated for severe thoracic injuries over the last 10 years. A thoracotomy was necessary in 14% of the patients with blunt trauma (BT) and 33% with penetrating trauma (PT). Thoracotomy for PT was performed earlier and had better results than thoracotomy for BT. Seventy-five percent of PT were operated in the first hour after admission against 29% of BT. Postoperative mortality for PT was three times lower than for BT (18% vs 56%). Reasons for this are the higher rate of injuries associated with BT. Surgical procedure depends on the type and extent of the thoracic and general injuries and on the patient's general condition.
通过重症监护、胸腔引流和合理的物理治疗,大多数胸部损伤都能得到充分治疗。在过去10年中,有571例患者接受了严重胸部损伤的治疗。钝性创伤(BT)患者中有14%需要进行开胸手术,穿透性创伤(PT)患者中有33%需要进行开胸手术。PT的开胸手术比BT的开胸手术进行得更早,效果也更好。75%的PT患者在入院后第一小时内接受了手术,而BT患者这一比例为29%。PT的术后死亡率比BT低三倍(18%对56%)。原因是与BT相关的损伤发生率更高。手术方式取决于胸部和全身损伤的类型和程度以及患者的一般状况。