创伤性浮动胸壁治疗探讨（Treatment of traumatic floating chest wall）.docVIP

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创伤性浮动胸壁治疗探讨（Treatment of traumatic floating chest wall）.doc

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创伤性浮动胸壁治疗探讨（Treatment of traumatic floating chest wall）

创伤性浮动胸壁治疗探讨（Treatment of traumatic floating chest wall） Treatment of traumatic floating chest wall 2009-04-18 Guo Jintang, Yushan Wang, Niu Min, Li Shuwen From January 1989 to June 1999, 36 cases of traumatic floating chest wall were treated, and the treatment of non fixed therapy, fixed therapy and mechanical ventilation was summarized: 1 data and methods 1.1 36 cases of general information, 31 males and 5 females, aged 8 to 62 years, of whom 16 years to 55 years old, 26, accounting for 72.2%, mostly in young adults. There were 35 cases of closed injury and 1 cases of open injury. There were 27 cases of unilateral multiple rib fractures, of which 15 were left, 12 were right and 9 were bilateral. Patients have different degrees of chest deformity, there are contradictions movement, difficulty breathing, blood sputum, chest pain, breathing with cyanosis. Blood gas analysis and arterial partial pressure of oxygen showed decreased in different degrees, PaO2, 6.3kPa to 10.0kPa. Of the 36 cases were with different degrees of hemothorax or pneumothorax, pulmonary contusion, 21 cases of hemoptysis, breathing is low or rales, X-ray showed unilateral or bilateral lung field widely ranging from the size of the lamellar patchy shadow 4 cases with respiratory distress; otherwise, PaO2 8kPa ARDS. There were 4 cases of sternal fracture, 6 cases of scapular fracture, 6 cases of clavicle fracture, 2 cases of bronchial injury, 4 cases of splenic rupture or splenic hematoma, 2 cases of renal contusion, 1 cases of heart contusion, 6 cases of craniocerebral injury, 8 cases of pelvic and limb fractures. Traumatic asphyxia occurred in 3 cases and shock in 9 cases. 1.2 treatment and outcome measures: small floating chest wall, partial compression chest belt fixation, back injury is not fixed. Large floating chest wall, obvious abnormal breathing movement, towel clamp sliding traction, and some simultaneous tracheotomy, sputum suction, oxygen supply, anti shock treatment. 2 cases were rep