开放期刊系统

连枷胸伴肺挫伤的救治进展

赵 雪梅

摘要

连枷胸是指出现3根2处以上的骨折,破坏了胸廓的连续性,骨折位置的胸壁丧失支撑,以致出现浮动胸壁及反常呼吸的损伤。这是最严重的一种胸壁钝性外伤,同时患者大部分存在肺部挫伤的问题,患者的生命安全也面临一定的威胁。因此,本文对连枷胸伴肺挫伤的救治进展做一综述,以供临床参考。

关键词

连枷胸;肺挫伤;救治进展

全文:

PDF

参考

[1]Allen GS,Coates NE. Pulmonary contusion:a collective review. Am Surg.1996;62:895-900.

[2]Clark GC,Schecter WP,Trunkey DD. Variables affecting outcome in blunt chest t ra uma:flail chest v s. pul mo n ar y con tu sio n .

J Trauma . 1988;28:298-304.

[3]Maloney Jv Jr,Schmutzer KJ,RaschkeE. Paradoxical respiration and “Pendelluft”. ThiracCardiovascSurg,1961,41∶291.

[4]Oppenheimer L,et al. Pathophysiology of pulmonar y contusion in dogs.J Appl Physiol . 1979;47:718-728.

[5]Hellinger A,et al. Does lung contusion affect both the traumatized and the noninjured lung parenchyma? A mor phological and mor

phometric study in the pig. J Trauma . 1995;39:712-719.

[6]Fulton RL,Peter ET. Physiologic effects of fluid therapy after pulmonary contusion.Am J Surg. 1973;126:773-777.

[7]Davis KA,et al. Prostanoids:early mediators in the secondary injury that develops a fter unilateral pulmona r y c ontusion. J Trauma .

1999;46:824 Y 831;discussion 831-832.

[8]Hellinger A,et al. Does lung contusion affect both the traumatized and the noninjured lung parenchyma? A mor phological and mor

phometric study in the pig. J Trauma . 1995;39:712-719.

[9]Perl M,et al. Pulmonary contusion causes impairment of macrophage and lymphocyte immune functions and increases mortality

associated with a subsequent septic challenge. Crit Care Med . 2005;33:1351-1358.

[10]蒋耀光. 连枷胸的病理生理与治疗问题. 创伤杂志,1987,3(4)∶218.

[11]赵鹤亮,肖永红,张惠英多旋螺旋 CT 在肺挫伤诊断中的应用.山东医药,2010,50(28):81-82.

[12]MillerPR,CroceMA,BeeTK,et a.l ARDS after pulmonary contusion:accurate measurement of contusion volume identifies high risk

patients. Trauma Injury,2001,51(2):223-230.

[13]BalciAE,BalciTA,ErenS,et al.Unilateral post traumatic pulmonary contusion:finding so fareview. SurgToday,2005,35(3):

205-210.

[14]Trinkle JK,et al. Pulmonary contusion. Pathogenesis and effect of various resuscitative measures. Ann Thorac Surg . 1973;16:

568-573.

[15]Richardson JD,et al. Pulmonary contusion and hemor rhageVcr ystalloid versus colloid replacement. J Surg Res. 1974;16:330-336.

[16]万春友,金鸿宾,王若明. 创伤性连枷胸与肺挫伤,中国危重病急救医学,1997,4(9):248-250.

[17]徐声辉. 连枷胸 47 例临床诊治分析. 中华创伤杂志,1991,7(3)∶153.

[18]Bruce Simon,MD,James Ebert,MD,Faran Bokhari,MD,et al. Management of pulmonary contusion and flail chest:An Eastern

Association for the Surgery of Trauma practice management guideline. Trauma Acute Care Surg.2012;73:351-361.

[19]Balci AE,et al. Open fixation in flail chest:review of 64 patients. Asian Cardiovasc Thorac Ann. 2004;12:11-15.

[20]Tanaka H,et al. Surgical stabilization of internal pneumatic stabilization?A prospective randomized study of management of severe

flail chest patients. J Trauma . 2002;52:727-732;discussion 732.

[21]Voggenreiter G,et al. Operative chest wall stabilization in flail chestYoutcomes of patients with or without pulmonary contusion. Jam

Coll Surg . 1998;187:130-138.

[22]滕继平,倪达,程佑爽,等.急诊手术内固定对创伤性连枷胸患者血流动力学的影响,上海交通大学学报医学版 2010,30

(12):1486-1489.

[23]蒋耀光. 胸部创伤诊治的进展. 创伤外科杂志,2003,5(5):321-324.

[24]Trinkle JK,et al. Management of flail chest without mechanical ventila-tion. Ann Thorac Surg . 1975;19:355-363.

[25]Shackford SR,Virgilio RW,Peters RM. Selective use of ventilator therapy in flail chest injury. J Thorac Cardiovasc Surg . 1981;

81:194-201.

[26]Sladen A,Aldredge CF,Albar ran R. PEEP vs. ZEEP in the treatment of flail chest injuries. Crit Care Med . 1973;1:187-191.

[27]Schweiger JW,Downs JB,Smith RA. Chest wall disr uption with and without acute lung injury:effects of continuous positive airway

pressure therapy on ventilation and perfusion relationships. Crit Care Med. 2003;31:2364-2370.

[28]Tanaka H,et al. Pneumatic stabilization for flail chest injury:an 11-year study. Surg Today. 2001;31:12-17.

[29]Voggenreiter G ,NeudeckF ,AufmkilkM,et al. Intermittent prone positioning in the treatment of severe and moderate

posttraumaticlung injury. Crit Care Med,1999,27(11):2375- 2382.


(6 摘要 Views, 28 PDF Downloads)

Refbacks

  • 当前没有refback。