创伤性浮动胸壁治疗探讨.docxVIP

创伤性浮动胸壁治疗探讨 Traumatic floating thoracic wa11 therapy is discussed The 2009-04-18 The king of guo jintang, shang li, li shu-wen niu min Since from January 1989 to June 1999 treated traumatic floating chest wall 36 cases, now is the adoption of fixed therapy and fixed therapy and mechanical ventilation treatment to summarize, the report is as follows: 1 data and methods There were 36 cases of men in 36 cases, 5 women, 8 years and 62 years of age, including 26 cases of 16 to 55 years of age, 72. 2 percent, more in youth and youth. 35 cases of closed injury, 1 case of open injury. There were 27 cases of unilateral multiple rib fractures, 15 of them on the left, 12 on the right, and 9 in both sides? The patient has various levels of thoracic collapse deformity, with the breath have contradictory motion, breathing difficulty, blood phlegm, cyanosis, chest pain. Blood gas analysis, arterial oxygen partial pressure showed different levels of decrease, Pa02 6. 3 kPa ~ 10. 0 kPa? This group of 36 cases with hemothorax and pneumothorax, and differe nt degree of pulm on ary contusion, including 21 cases of hemoptysis, low breath sounds or rale, X ray film showed unilateral or bilateral lung field in widely varying size sheet flocculent shadow; There are four other cases of respiratory distress, Pa02 8kPa for ARDS? Sternal fracture in 4 cases, 6 cases of scapula fracture, 6 cases of clavicle fracture, bronchial injury in 2 cases, splenic rupture or spleen hematoma in 4 cases, 2 cases of renal contusion, thoracic injury in 1 case, 6 patients with craniocerebral injury, pelvis, and 8 cases of limbs fracture? Traumatic asphyxiation 3, shock 9. Treatment and outcome treatment: the small band of floating thoracic wall was fixed with topical compression of the chest, and the back injured were not fixed? Large scale floating thoracic wall, obviously abnormal breathing movement towel c1amp sliding traction, some simultaneously make the trachea cut up the phlegm, supply oxygen, anti-sh