Frezza E E, Siram S M, Van Thiel D H, Mezghebe M H
Department of Surgery, Howard University Hospital, Washington, D.C., USA.
J Cardiovasc Surg (Torino). 1996 Oct;37(5):521-4.
Venous thromboembolism has been recognized as a potentially life-threatening complication following major thoracic trauma. Little or no attention has been directed at the difference in rates of venous thromboembolism in subjects with penetrating and nonpenetrating chest trauma.
The reported experience with venous thromboembolism in subjects with chest trauma has not segregated the effect penetrating vs. closed chest trauma. The influence of long-term hospitalization to the formation deep vein thrombosis, pulmonary embolism or subsequent death. The present study evaluated the causes of early death occurring within 96 hours of hospitalization for penetrating chest trauma. The clinical records and autopsy reports of 32 individuals, who died within 96 hours of admission to hospital for penetrating chest trauma, were evaluated for the presence of deep vein thrombosis and pulmonary embolism.
All 32 subjects were male with an average age of 31 years. Eighty percent were successfully resuscitated in the emergency room. Forty percent (40%) required an emergency or operating room thoracotomy. The initial revised trauma score (RTS) was below 4 in each case. Thirty-two percent (32%) of the patients died on the fourth day; 48% died between 1 and 3 days of admission and 20% died in the emergency room. None of the patients had any clinical signs or evidence of deep vein thrombosis or pulmonary embolism. Moreover, the autopsy findings were negative for deep vein thrombosis and pulmonary embolism.
Deep vein thrombosis and pulmonary embolism is rarely a cause of death within the initial 96 hours of hospitalization in individuals sustaining penetrating chest trauma.
静脉血栓栓塞已被公认为是严重胸部创伤后潜在的危及生命的并发症。对于穿透性和非穿透性胸部创伤患者静脉血栓栓塞发生率的差异,很少或几乎没有受到关注。
既往关于胸部创伤患者静脉血栓栓塞的报道未区分穿透性与闭合性胸部创伤的影响。长期住院对深静脉血栓形成、肺栓塞或随后死亡的影响。本研究评估了穿透性胸部创伤患者住院96小时内早期死亡的原因。对32例因穿透性胸部创伤入院后96小时内死亡的患者的临床记录和尸检报告进行评估,以确定是否存在深静脉血栓形成和肺栓塞。
所有32例患者均为男性,平均年龄31岁。80%在急诊室成功复苏。40%需要急诊或手术室开胸手术。每例患者最初的修正创伤评分(RTS)均低于4分。32%的患者在第4天死亡;48%在入院后1至3天死亡,20%在急诊室死亡。所有患者均无深静脉血栓形成或肺栓塞的任何临床体征或证据。此外,尸检结果显示深静脉血栓形成和肺栓塞均为阴性。
对于穿透性胸部创伤患者,深静脉血栓形成和肺栓塞很少是住院最初96小时内的死亡原因。