摘要
目的 探讨重度肺挫裂伤的发生机理、诊断及治疗。方法 对重度肺挫裂伤的发病机理及临床相关问题作了综合分析研究。通过动物实验与临床研究 ,推断重度肺挫裂伤的发生与机体一系列应激保护反应关系密切 ,即机体在受到意外伤害前深吸气、声门紧闭、全身肌肉强裂收缩、膈肌下降、肋骨上升极限达到与脊柱垂直时 ,胸廓容积达极限 ,肺达到最大限度膨胀 ,肺内压达到最高 ,此时胸廓对胸内脏器的保护及对抗外界暴力达到最大限度。当胸廓这一保护不足以对抗外界强大暴力时 ,胸廓的极大变形致胸腔容积瞬间缩小与肺内极高的压力致肺组织广泛挫裂伤。并根据肺挫裂伤从伤后到临床出现明显呼吸困难需要一定的时间 ,提出早期诊断及早期治疗的重要性。结果 重度肺挫裂伤经吸氧等综合治疗呼吸困难不能改善 ,血氧分压低 ,血氧饱和度低于85 %并进行性下降者 ,要及时果断采取呼吸机辅助呼吸方可明显提高治愈率。结论 要提高外科医生对重度肺挫裂伤的认识及诊治水平。
Objective To analyse the pathogenesis,diagnosis and therapy for severe lung contusion.Methods 38 cases of severe lung contusion were observed.On the basis of lung contusion,the patients suffered from mltiple organs trauma,or abdomino-thoracic combinative trauma all of the patients were comprehansive treated with assited ventilation,antishock,high dasage hormone in short-time,dehydrating agent and diuretics therapy etc.Simultaneously,all of concurrent trauma were also reasonably managed timely which including closed thoracic drainage,open chest hemostasis,scavenging hematoma with craniotomy laparosplenotomy,hepatospleno-repair,gastroenterostomy,lower or upper extremity open reduction and extration etc.Results By oxygen inhalation comprehensive treatment did not improve the dyspnea symptom of severe lung contusion when the blood oxygen saturation was lower than 85% and further fall,the severe lung contusion patients were obviously improved by assited ventilation with respirator.Conclusions Using assited ventilation could raise the cure rate for the severe lung contusion,and simultaneously,early diagnosis and comprehansive treatment in time have identical importance.
出处
《中国医师杂志》
CAS
2003年第5期613-614,共2页
Journal of Chinese Physician
关键词
重度肺挫裂伤
发生机制
辅助呼吸
Lung severe contusion
Pathogenesis
Ventilator-improved-respiration
