胸外科常见疾的病肋骨骨折与气胸.ppt

胸外科常见疾病;胸部解剖与生理;胸部解剖与生理;胸膜腔 ;胸膜腔 Pleural cavity;胸部解剖与生理;胸膜腔负压Intrapleural pressure：;负压作用： ;呼吸动作 ;呼吸动作;胸部解剖特点;胸外科常见疾病; 发病率和死亡率: Chest trauma accounts for 8% occurrences of total traumatic cases, more than 25% of death caused by trauma.;胸部损伤分类; 胸外伤病因;病因: A.减速性暴力 B.挤压性暴力 C.撞击性暴力 D.冲击性暴力 程度:(较轻) A.肋骨或胸骨骨折 B.肺组织顿挫伤 ARDS,心力衰竭 C.心脏顿挫伤。 特点: 多数病人不需要开胸手术治疗;穿透伤;闭合性损伤 Closed injury ;开放性损伤 Open injury ;压力波造成组织破坏撕裂血管，破坏肺泡组织破坏气管支气管树 创伤性膈肌破裂 ;穿透伤合并损伤;呼吸困难呼吸疼痛通气不足捻发音胸壁矛盾运动 ;肋骨骨折（Rib Fractures） 50% of significant chest trauma cases due to blunt trauma Compressional forces flex and fracture ribs at weakest points Ribs 1-3 requires great force to fracture Possible underlying lung injury Ribs 4-9 are most commonly fractured Ribs 9-12 less likely to be fractured Transmit energy of trauma to internal organs If fractured, suspect liver and spleen injury Hypoventilation is COMMON due to PAIN;(一）肋骨骨折定义;二、病因;易发部位 1～3 4～7 8～10 11～12 ;多根多处肋骨骨折;连枷胸;反常呼吸运动;肋骨骨折并发症;治疗方法;治疗方法;治疗方法;治疗方法;Sternal Fracture Dislocation （胸骨骨折和错位） Associated with severe blunt anterior trauma Direct Blow (比如：方向盘) Incidence: 5-8% Mortality: 25-45% Myocardial contusion Pericardial tamponade Cardiac rupture Pulmonary contusion Dislocation uncommon but same MOI as fracture Tracheal depression if posterior ;自发性气胸;气胸- -定义：;概述;概述;概述;临床表现;临床表现;影像学检查;影像学检查;影像学检查;影像学检查;影像学检查;影像学检查;影像学检查;影像学检查;影像学检查;影像学检查;诊 断;临床分型;临床分型;临床分型;请在此处添加标题;治疗;治疗;治疗;治疗;治疗;胸腔引流管插入的位置 ;;胸腔闭式引流术Thoracic closed drainage;胸腔闭式引流术适应症;治疗