Keywords: Endometritis

Objective To analyze the characteristics of 720 cases of chest trauma types and injuries. Methods The cases were divided into two groups: group A (0996 1990 ~ 65438+355 cases) and group B (2003 1997 ~ 365 cases). Statistical data, chi-square test. Results The number of cases of traffic accident injury, hemopneumothorax, sternal rib fracture and compound injury in group B was significantly higher than that in group A (P < 0.0 1). The number of other injuries in group B was significantly lower than that in group A (P

Keywords types of chest trauma

Chest trauma is one of the common diseases in thoracic surgery, but it has been rarely reported in recent years. We retrospectively analyzed all kinds of chest trauma cases from 1990 to 2003, and found that the etiology and injury degree of chest trauma changed obviously during 14. The summary report is as follows.

1 data and methods

720 cases of chest trauma, aged from 4 to 80 years old, including 583 males, female 137, male: female =4.26: 1. There were 355 cases from 1.990 to 1.996 to 1.02 (group A) and 365 cases from 1.997 to 1.03 (group B). The causes of injury are divided into various traffic accidents (such as motor vehicle collision, subversion, cyclists and pedestrians being hit). ), other injuries (such as fist injury, blunt instrument injury, sharp instrument cutting and stabbing, etc. ), falling from a height (such as falling on the construction site, attic, etc.). ), as well as accidental injuries (such as drunk cycling, iron filings, rock blasting, scooter handle injury, unstable walking injury, etc. Among the 300 traffic accidents, there were 60 in group A and 0/36 in group B; There were 23 cases of hemopneumothorax in group A and 56 cases in group B. Combined with other complicated injuries (such as liver, spleen, kidney, intestine rupture, clavicle fracture, spinal trauma, craniocerebral injury, etc.), there were 42 cases in group A and 94 cases in group B. ). Among 237 cases of other injuries, there were 22 cases in group A and 27 cases in group B with sternal rib fracture. There were 28 cases of hemopneumothorax in group A and 38 cases in group B. There were 49 cases in group A and 36 cases in group B.. Among 82 cases of falling injuries, there were 20 cases in group A and 43 cases in group B with sternal fractures. There were 9 cases of hemopneumothorax in group A, and 9 cases in group B 1 1. There were 9 cases in group A and 9 cases in group B 1 1 case, all of which had other complicated injuries. Among other accidental injuries 10 1 cases, there were 50 cases in group A 12 and group B; Patients with hemopneumothorax were 1 1 in group A and19 in group B; There were 6 cases in group A and 7 cases in group B complicated with other injuries. Among the dead, there were 5 traffic accident injuries, 3 other injuries, 2 falling injuries and accidental injuries 1 case. Everyone else recovered and was discharged. Statistics and analysis of data, chi-square test, P

Note: ˇ p < 0.0 1, ˇ p > 0.05，ˇˇP & lt； 0.05。 The number of traffic accident injuries in group B was significantly higher than that in group A, and the number of other injuries was significantly lower than that in group A, with significant difference between the two groups (P

Note: △ p

In traffic accident injuries, there were significant differences in rib fracture and compound injury between group B and group A (P

3 discussion

In the past decade, China's national economy has grown steadily year by year, and various constructions, especially infrastructure construction and road traffic construction, have developed rapidly. The automobile industry is rising rapidly at an unprecedented speed, attracting worldwide attention. However, because the road construction lags behind the growth of the number of cars, the road traffic management force is relatively insufficient, the personnel flow is soaring, the public and drivers' awareness of road safety is relatively weak, and the road traffic accidents, especially the vicious accidents of group deaths and group injuries, are on the rise, and the degree of injury tends to be relatively aggravated. Such reports are often seen in newspapers, similar to those of foreign industrialized countries [1]. Statistically speaking, there is no significant difference between chest injuries caused by falling from a height in construction sites and other accidents in 14, which reflects that governments at all levels and safety production management departments attach great importance to safety production, employees' safety awareness is greatly improved, and labor protection measures are fully implemented. The continuous improvement of the country's legal system construction, the strengthening of the crackdown on various illegal and criminal activities, and the further improvement of the social security situation have significantly reduced the number of other injury cases. It is worth noting that in recent years, among all kinds of chest injuries, the severity of sternal rib fracture, hemopneumothorax and compound injury has increased significantly. On the one hand, it is necessary to strengthen the publicity of road traffic regulations and safety production knowledge, gradually improve various safety protection measures, enhance people's awareness of self-protection, and strive to reduce the incidence of various chest injuries, especially serious injuries. On the other hand, clinical workers should be reminded to strengthen their sense of responsibility, and when accepting patients with chest injuries, they should be highly alert to injuries related to other parts and systems, and beware of adverse consequences caused by misdiagnosis and missed diagnosis.

1327 Clinical Treatment of Chest Trauma

Keywords: chest trauma

Chest trauma; Diagnosis; Get (a patient) out of danger.

Clinical data of 1

1970? 1 1/2004? In Room 03, 327 patients (male 1006, female 32 1) with the age ranging from 2 to 86 years (average 33.8 years) were treated with chest trauma. There were 86 children (≤ 12 years old) and 39 elderly people (≥60 years old). There were 232 cases of shock at admission, coma 134 cases, acute circulatory dysfunction 103 cases and acute respiratory insufficiency 126 cases, of which type I (ventilation) was included. Grade Ⅲ (secondary lung disease) in 42 cases. Among the three types of respiratory dysfunction, 28 cases developed into acute respiratory distress syndrome (ARDS), and 925 cases (69.7%) were closed chest injuries, among which traffic accidents were the most common, followed by falls, contusions, blunt injuries, blast injuries and animal kicking injuries. There were 402 cases (30.3%) of open chest injuries, among which sharp instrument injuries were the most, followed by needle injuries, bullet injuries, shrapnel injuries, steel bar injuries and wooden sticks injuries, and 82 cases were complicated with cardiovascular injuries, including 28 cases of blunt injuries, 42 cases of penetrating injuries and iatrogenic injuries 12 cases. Lung contusion 49 1 case; Combined thoracoabdominal injury 120 cases, of which 39 cases caused diaphragmatic hernia; Multiple injuries: craniocerebral injury 144 cases, abdominal organ injury in 206 cases, trunk or limb fracture 174 cases, rib fracture in 823 cases (including flail chest 102 cases), pneumothorax in 866 cases and bronchial rupture in 38 cases. 1304 cases (98.3%) survived. According to the injuries of chest trauma and combined injuries, 13 cases (56.5%) died of chest trauma combined with multiple injuries, 4 cases (17.4%) died of cardiovascular injuries, 4 cases (17.4%) died of combined injuries of chest and abdomen, and 2 cases (8.7%) died of others. According to the treatment time, 6 cases died of ARDS in the middle and late stage (26. 1%), 5 cases died of multiple organ dysfunction (2 1.7%), 4 cases died of heart failure (17.4%), and 4 cases died of hemorrhagic shock in the early stage (/kloc-).

2 discussion

The treatment of chest trauma is mostly an emergency in clinic, which requires comprehensive analysis, diagnosis and rescue at the same time, careful observation of the changes of the condition, timely treatment of the problems found, and good diagnosis and treatment of compound injuries and prevention of complications [1, 2]. Combined thoracoabdominal injury 120 cases in this group, 79 cases were correctly diagnosed before operation (65.8%). Therefore, before the initial consultation or the injury is not determined, it is still necessary to check at the same time and deal with the injured part according to the priority, so as not to delay the rescue opportunity. Flail chest should be fixed in time. In this group, 57 cases were fixed by self-made multifunctional buckled chest strap, and 45 cases were fixed by chest traction. There were 2,565,438+0 cases in the whole group, including 62 cases of simple hemostasis and blood clot removal, 40 cases of lung repair, and 665,438 cases of wedge resection or lobectomy. There were 34 cases of bronchial anastomosis, 4 cases of pneumonectomy, 52 cases of diaphragm repair and 58 cases of emergency cardiac laceration repair. For patients with combined thoracoabdominal injuries and multiple chest injuries, laparotomy should be performed when necessary. Due to severe chest trauma, pulmonary capillary permeability increased, and a large number of plasma components spread to interstitial lung through intercellular pores expanded by endothelial cells. This exudate can form an eosinophilic fibrin membrane on the alveolar wall, preventing the mutual diffusion of O2 and CO2.