Subotić D, Mandarić D, Radovanović D, Ercegovac M
Institut za plućne bolesti i TBC Srbije.
Acta Chir Iugosl. 1995;42(1):49-54.
Influence of performed diagnostic and therapeutic procedures on the outcome of the treatment of traumatic hemopneumothorax during isolated chest trauma. The aim of this study is the assessment of the influence of performed diagnostic and therapeutic procedures on the outcome of hemopneumothorax as a part of isolated chest trauma. The main group consists of 51 patients with hemopneumothorax. Patients with pneumothorax without effusion represent the first control group; the second control group consist of patients treated because of iatrogenic pneumothorax. In the main and control groups the analysis of clinical, roentgenographic and functional parameters was made, together with the analysis of particular therapeutic procedures, the estimation of the success of the treatment was based on roentgenographic and functional parameters. The higher incidence of hemopneumothorax compared with control groups during chest trauma in the analyzed material is statistically significant. The occurrence of bilateral hemopneumothorax in 10% of cases emphasizes the need of adequate roentgenographic assessment of injured patients. Regardless of the intensity of the trauma, symptoms do not always indicate the existence of hemopneumothorax. The number of fractured ribs is not of significant importance in terms of the occurrence of hemopneumothorax or pneumothorax. Severe dyspnea can be accompanied even with a smaller collapse of the lung independently of the amount of blood in the pleural cavity. Oxygenation in the arterial blood is impaired with the great and small pulmonary collapse. Hemodynamic disorders existed in 14% all cases. The higher frequency of operative treatment in the main group is statistically significant. The majority of cases of traumatic hemopneumothorax can be successfully treated by the conservative treatment. Accompanying complications do not have greater influence on the outcome.
所实施的诊断和治疗程序对单纯胸部创伤时创伤性血气胸治疗结果的影响。本研究的目的是评估所实施的诊断和治疗程序对作为单纯胸部创伤一部分的血气胸治疗结果的影响。主要组由51例血气胸患者组成。无胸腔积液的气胸患者代表第一对照组；第二对照组由因医源性气胸接受治疗的患者组成。在主要组和对照组中，对临床、X线和功能参数进行了分析，同时对特定治疗程序进行了分析，治疗成功的评估基于X线和功能参数。在所分析的资料中，胸部创伤时血气胸的发生率高于对照组，具有统计学意义。10%的病例出现双侧血气胸，这突出了对受伤患者进行充分X线评估的必要性。无论创伤的严重程度如何，症状并不总是表明存在血气胸。肋骨骨折的数量对于血气胸或气胸的发生并不重要。即使肺萎陷较小，严重呼吸困难也可能出现，而与胸腔内血液量无关。无论肺萎陷大小，动脉血中的氧合都会受损。14%的病例存在血流动力学紊乱。主要组手术治疗频率较高具有统计学意义。大多数创伤性血气胸病例可通过保守治疗成功治愈。伴随的并发症对治疗结果影响不大。
