严重胸部损伤合并颅脑伤的早期诊治（Early diagnosis and treatment of severe chest trauma combined with craniocerebral trauma）.docVIP

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严重胸部损伤合并颅脑伤的早期诊治（Early diagnosis and treatment of severe chest trauma combined with craniocerebral trauma）.doc

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严重胸部损伤合并颅脑伤的早期诊治（Early diagnosis and treatment of severe chest trauma combined with craniocerebral trauma） Early diagnosis and treatment of severe chest trauma combined with craniocerebral trauma Update Date: 2010-10-08, Xia Xiaoming, Zhao Hanwei, Xia Wei, Li Zhaohui Severe chest injury associated with craniocerebral injuries often cause respiratory and circulatory dysfunction, serious illness, sudden changes, the mortality rate is high, such as to give timely and correct diagnosis, early and effective treatment, can significantly reduce the mortality, create conditions for further rescue. In our hospital from 1987 to 1997 years were treated with severe chest injury in 367 cases, of which 58 cases were combined with craniocerebral injury, injury severity score (ISS) method, the ISS value is more than 20. The principle of early diagnosis and treatment is discussed as follows. clinical data 1. general situation: there were 46 males and 12 females in the 58 cases, aged 18~65 years. There were 44 cases of traffic accident, 8 cases of falling injury, 6 cases of wall collapse. The rescue time was 1 hours after injury, 23 cases in 1~3 hours after injury, 7 cases in 28 hours and 4~8 hours after injury. 2. clinical manifestations: (1) shock: when the patient came to the hospital for the first time, the systolic blood pressure was less than 12kPa (1kPa=7.5mmHg) in 23 cases, less than 8kPa in 6 cases, the systolic pressure dropped to 3 to 8kPa in 28 cases, and 8 to 12kPa in 12 cases. (2) the chest injury; 36 cases of closed chest injury, 16 cases of open chest injury; side softening of chest wall in 32 cases, 5 cases of bilateral chest wall softening, multiple rib fractures in 21 cases without softening of chest wall; acute cardiac tamponade complicating side in 3 cases; 46 cases of pneumothorax, 9 cases of bilateral pneumothorax, 3 cases of tension pneumothorax. Dyspnea was found during the visit, including 14 cases with respiratory obstruction, chest X-ray examination in 12