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[胸主动脉破裂及多处损伤]

[Rupture of the thoracic aorta and multiple injuries].

作者信息

Solheim K, Pillgram-Larsen J, Fjeld N B

机构信息

Kirurgisk klinikk, Ullevål sykehus, Oslo.

出版信息

Tidsskr Nor Laegeforen. 1993 May 10;113(12):1471-4.

PMID:8332977
Abstract

Traumatic rupture of the thoracic aorta is an extremely severe injury, and is usually fatal. The injury is most often seen in forceful deceleration trauma. This complicates the priority of diagnosis and treatment in relation to other severe injuries in the same patient. During the period 1984-1991, nine patients underwent operation for this injury at the Department of Thoracic Surgery. Two patients succumbed, because of free rupture in the operating theatre. The others survived. Three of these were treated by directly suturing the rupture, and four by introducing a prosthesis. The prognosis in operated traumatic rupture of the thoracic aorta is good if the haematoma is contained. Relevant history of deceleration and suspicion of mediastinal widening should lead to arcography and prompt operation if the diagnosis is confirmed. Only significant intraabdominal or intracranial hemorrhage supersede aortic rupture in the initial priorities for treatment.

摘要

创伤性胸主动脉破裂是一种极其严重的损伤,通常会致命。这种损伤最常见于强力减速创伤。这使得与同一患者的其他严重损伤相关的诊断和治疗优先级变得复杂。在1984年至1991年期间,9例患者在胸外科接受了该损伤的手术治疗。2例患者因在手术室出现游离破裂而死亡。其他患者存活。其中3例通过直接缝合破裂处进行治疗,4例通过植入假体进行治疗。如果血肿得到控制,手术治疗的创伤性胸主动脉破裂预后良好。有相关的减速病史且怀疑纵隔增宽时,若确诊应进行血管造影并及时手术。在最初的治疗优先级中,只有严重的腹腔内或颅内出血比主动脉破裂更为紧急。

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