【摘要】 外伤性连枷胸的治疗,以往一直以胸壁软化、反常呼吸、气胸摆动为理论基础而采取胸壁固定为主的治疗措施。作者在临床实践中发现,连枷胸的病理生理改变主要是损伤胸壁下的肺的挫伤,而不是胸壁软化,反常呼吸和气胸摆动。胸壁固定仅限于防止软化胸壁的骨折断端造成或继续造成肺组织的挫裂伤。本组按下述肺挫伤的治疗原则处理:①确保呼吸道通畅,维持有效呼吸。必要时行气管切开;②充分止痛;③由血气分析监测氧浓度,必要时使用呼吸机;④严格控制输液量,尤其应限制晶体液的输入;⑤及时引流胸腔;⑥尽早提高血浆渗透压;⑦早期使用糖皮质激素,首选地塞米松;⑧选用广谱抗茵素防感染。如此取得较为满意的疗效。更多还原

【Abstract】 The injured flail chest used to be treated mainly by fixing the chest wall, based on the therory ot the treatment oi the sofning wall, the abncrmal breathing and the swinging pneumothorax. In the authors’ cinical experience, the pathophysiological changes oi the flail chest are Probably the contusions of the part of the lungs under the injured wall, ut not the sofning of the wall, the abnormal breathing and the swinging of the pneumothorax. The fixing of the wall is limited in Preventing the broken end of the sofning wall from causing the contusions of the lungs. This article described the treatments of the contusions of the lungs as follows: 1.ensuring the unimpeded respiratory tract and normal breathing, incising the tract when necessary; 2.relieving pain; 3.determining the concentration of blood-oxygeon by blood gas analysis, using respirators when necessary; 4.stricly controlling the amount of fluid infusion, especially of the fixing body fluid’s; 5.Performing the timel ydrainage of the effusions in the thoracic cavity; 6.raising the pressure of plasma osmosis as soon as possible; 7.using cortical hormone; 8.using w ide-spetrum antibiotics againsti nfection. These methods were found effective intreating the injury,更多还原