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| 題 名 | The Management of Chest Trauma--A 16 years' Experience=胸部外傷的十六年治療經驗 |
|---|---|
| 作 者 | 高英隆; | 書刊名 | 中華民國外科醫學會雜誌 |
| 卷 期 | 25:1 民81.01-02 |
| 頁 次 | 頁993-999 |
| 分類號 | 416.22 |
| 關鍵詞 | 胸部外傷; |
| 語 文 | 英文(English) |
| 中文摘要 | 高雄醫學院胸腔外科從民國62年元月至78年6月所收集的668例胸部外傷病例中,男性570例,女性98例。年齡由8個月至77歲,平均年齡為36.0歲。經加以分析,我們發現: 胸部外傷病人的年度病例數雖然沒有明顯的增減,但外傷病例對於胸腔外科住院病人數的比率,卻明顯的逐年下降,意味著地區醫院的增長及胸部外傷病患處理的普及,可說教學醫院已不再是胸部外傷病患的急救中心。 外傷原因以交通事故(48.4%)及銳器損傷(27.5%)居多。29例的醫源性傷害多集中於早期的三分之一病例中;子彈傷的病例數,最近略有增加。顯示本地區社會環境的改變。 治療上仍以胸管置放來改善血、氣胸的情形最多。病例中因氣管斷裂、大出血、肺挫裂傷、橫膈破裂或臟器損傷等原因而需手術治療者,計有83例。手術死亡率為6.0%。668例胸部外傷的死亡率 為7.9%。胸部外傷的死亡與合併外傷的多寡有密切關係。合併外傷愈多,其死亡率也愈高。當病人有三處或三處以上的合併外傷時,其死亡率則高達40%。 |
| 英文摘要 | In reviewing 668 cases of chest trauma from January 1973 through June 1989, we found that there has been a decreasing ratio of traumatic patients compared with the patients examined annually in our chest surgical ward. This indicates that non-traumatic patients have become the majority at this college hospital. The causes of trauma were chiefly due to traffic accidents (48.4%) and stab wounds (27.5%). As medical technology has been improved, the incidence of iatrogenic injury has decreased. Among the 29 iatrogenically injured patients, only five were treated in the last two thirds of the study. Most of our patients received tube thoracostomy to correct the condition of pneumohemothorax. Only 83 cases needed open thoracotomies to treat tracheal injuries, massive hemorrhages, extensive lung parenchymal injuries, diaphragmatic ruptures and other visceral injuries. Five patients were lost during surgery. All deaths were caused by uncontrollable bleeding. In this series, the overall mortality rate was 7.9%. However, the more associated injuries the patients suffered from, the higher the rate of mortality. This rate reached a maximum of 40.0% among patients with three or more associated injuries. |
本系統中英文摘要資訊取自各篇刊載內容。