Allen G S, Cox C S
Department of Surgery, University of Texas-Houston Medical School and the Hermann Children's Hospital, USA.
South Med J. 1998 Dec;91(12):1099-106. doi: 10.1097/00007611-199812000-00002.
Pulmonary contusion (PC) is the most common injury identified in pediatric blunt chest trauma. The disagreement over management principles of children with PC may complicate care of these patients.
We reviewed the literature and our institutional experience.
Pulmonary contusion is most often diagnosed by chest roentgenogram, with computed tomography of the chest reserved for more precise evaluation of the mediastinum and aorta. Hypoxemia and respiratory mechanical insufficiency are the most common causes of morbidity from early chest injury. Complications include pneumonia and the adult respiratory distress syndrome, which together may occur in up to one half of all cases.
Early diagnosis, maintaining euvolemia, and selective mechanical ventilation may help to limit morbidity. Management guidelines based on the available literature may improve the care of these patients.
肺挫伤（PC）是小儿钝性胸部创伤中最常见的损伤。关于PC患儿治疗原则的分歧可能使这些患者的护理变得复杂。
我们回顾了文献及我们机构的经验。
肺挫伤最常通过胸部X线片诊断，胸部计算机断层扫描用于更精确地评估纵隔和主动脉。低氧血症和呼吸机械功能不全是早期胸部损伤最常见的发病原因。并发症包括肺炎和成人呼吸窘迫综合征，二者在所有病例中合计发生率可达一半。
早期诊断、维持血容量正常及选择性机械通气可能有助于降低发病率。基于现有文献的管理指南可能改善这些患者的护理。
