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find Keyword "挫伤" 22 results
  • 肺挫伤475例的临床诊断与治疗

    目的探讨肺挫伤的诊断和治疗方法,提高肺挫伤的治疗效果。方法回顾性分析 2006年 1月至 2011年 1月解放军第 161中心医院收治的 475例肺挫伤患者的临床资料,其中男 273例,女 202例;年龄(41.20±16.00)岁。经胸部 X线、CT检查确诊为肺挫伤。入院后紧急处理危及生命的伤情,保持呼吸道通畅,抗休克治疗,及时处理合并伤,控制活动性出血;注意控制输液量,尤其是限制晶体液的摄入量,其中采用限制性液体复苏 142例。行肋骨骨折内固定术 95例。机械通气 86例,给予潮气量 6~ 8 ml/kg,呼气末正压( PEEP)3~ 11 cm H2O。结果 82例患者同期行胸部 X线及 CT检查,其中胸部 X线诊断肺挫伤 72例(87.80%),CT确诊肺挫伤 82例(100.00%),两种方法诊断准确率差异有统计学意义( P< 0.05)。148例患者进行了治疗前和治疗 7 d后的血气分析检查,治疗后动脉血氧分压( PaO2)、动脉血二氧化碳分压( PaCO2)、动脉血氧饱和度( SaO2)及氧合指数( PaO2/FiO2)均较治疗前明显改善( P< 0.01)。全组治愈 439例(92.42%),死亡 36例(7.58%)。死于创伤性失血性休克 6例,重型颅脑损伤 11例,急性呼吸窘迫综合征( ARDS)14例,多器官功能不全综合征(MODS)5例。结论肺挫伤的诊断首选胸部 CT检查。严重合并伤和并发症是肺挫伤的主要死亡原因。积极救治合并伤,合理的胸壁固定,限制性液体复苏及保护性机械通气是提高肺挫伤疗效的重要途径。

    Release date:2016-08-30 05:49 Export PDF Favorites Scan
  • 有创-无创序贯性机械通气在肺挫伤致急性呼吸窘迫综合征中的应用价值

    目的 观察有创-无创序贯机械通气在肺挫伤致急性呼吸窘迫综合征( ARDS) 中的应用价值。方法 选择肺挫伤致ARDS 患者44 例, 随机分为序贯治疗组和对照组, 每组22 例。所有病例均气管插管行机械通气, 通气模式为同步间歇指令通气( SIMV) + 压力支持通气( PSV) + 呼气末正压( PEEP) 。当ARDS 控制窗出现时, 序贯治疗组依次选择双水平正压通气( BiPAP) 至停机通气模式, 对照组选择SIMV + PSV + PEEP 至停机通气模式。结果 序贯治疗组有创通气时间[ ( 4.5 ±2.5) d 比( 13.1 ±4.9) d] 、总机械通气时间[ ( 14±2) d 比( 19±1) d] 、呼吸机相关性肺炎( VAP) 发生率 ( 9.1%比40.9% ) 、ICU住院时间[ ( 17±3) d 比( 22±4) d] 、病死率( 13.6% 比31.8% ) 与对照组比较差异均有统计学意义( Plt;0.05) 。结论 有创-无创序贯机械通气是治疗肺挫伤致ARDS 的安全、有效的方法, 能明显缩短有创通气时间和总机械通气时间, 降低VAP发生率, 缩短ICU住院时间, 降低病死率。

    Release date:2016-08-30 11:56 Export PDF Favorites Scan
  • 23 Cases’ Clinical Analysis of Children Eye Hyphema Caused by Blunt

    摘要:目的:总结儿童眼球钝挫伤致前房积血的原因、临床表现以及最佳治疗方法。方法: 回顾分析四川大学华西医院2007年9月~2008年9月收治的眼球钝挫伤致前房积血23例的治疗:(1)半卧位休息;(2)双眼包扎或不包扎;(3)止血;(4)手术治疗。 结果: Ⅰ、Ⅱ级前房积血吸收快,出现继发性出血者常需要采取手术治疗,视功能恢复缓慢。结论: 早期积极恰当治疗,可减少继发性青光眼、角膜血染等并发症。Abstract: Objective: To summarize the reasons of children hyphema caused by blunt, clinical manifestations, as well as the best method of treatment. Methods: analysing the 23 cases history of eye hyphema from September 2007 to September 2008 in West China Hospital of Sichuan University caused by blunt. The treatments were: (1) semisupine rest; (2) eyes bandaged; (3) to use hemostatic medicine; (4) surgery. Results: Hyphema in Ⅰand Ⅱ class could be absorbed fastly.Secondary hemorrhage often need to be taken for surgical treatment, depending on the slow recovery of vision. Conclusion: Early appropriate and positive treatment can reduce secondary glaucoma, corneal complications such as blood.

    Release date:2016-09-08 10:12 Export PDF Favorites Scan
  • 手术内固定治疗创伤性连枷胸对患者呼吸功能的影响

    目的观察连枷胸患者胸壁加压包扎、肋骨牵引和手术内固定的治疗效果。 方法纳入2001年1月至2010年6月解放军第一医院心胸外科收治的56例连枷胸患者,分为3组:牵引治疗组,14例,其中男10例、女4例,年龄(39.7±11.6)岁;包扎治疗组,12例,其中男11例、女1例,年龄(40.2±13.2)岁;手术内固定组,30例,其中男26例、女4例,年龄(42.6±12.5)岁。比较3组的治疗效果。 结果手术内固定组与牵引治疗组和包扎治疗组比较,除需呼吸机支持率与牵引治疗组差异无统计学意义(P>0.05)外,呼吸机通气时间、住ICU时间、胸腔引流管拔除时间均缩短(P<0.05),胸部并发症发生率及死亡率降低(P<0.05),动脉血氧分压(PaO2)、动脉血氧饱和度(SaO2)显著升高(P<0.01),肺挫伤评分下降明显;而牵引治疗组PaO2、SaO2及肺挫伤评分较入院时改善缓慢,胸壁加压包扎治疗组甚至有加重趋势。 结论大面积浮动胸壁的病理改变以胸腔容积减少为基础,胸壁加压包扎无治疗效果,甚至加重低氧;肋骨巾钳悬吊牵引固定对连枷胸缺氧内环境的改善效果不佳;手术切开复位内固定是改善大面积浮动胸壁呼吸功能障碍的有效方法。

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  • Clinical analysis of thoracic exploration of chest trauma

    目的 探讨胸外伤开胸探查的手术指征及救治策略。 方法 回顾性分析我院自 2006 年 1 月至 2014 年 12 月经开胸探查救治 51 例胸外伤患者的临床资料,其中男 43 例、女 8 例,年龄 24(17~75)岁。 结果 全组损伤严重度评分(ISS)平均 19.4 分。闭合性损伤 16 例,开放性损伤 35 例,治愈 45 例(88.24%),死亡 6 例(11.76%)。死亡原因为心脏破裂、失血性休克、感染性休克、多器官功能障碍综合征(MODS)、弥散性血管内凝血(DIC)。 结论 及时就医、快速诊断、准确把握手术指征、多科室联合诊治是救治胸外伤的关键。

    Release date:2017-09-04 11:20 Export PDF Favorites Scan
  • 钝挫伤视神经缺血17例的眼底荧光血管造影分析

    眼底荧光血管造影(FFA)能早期发现钝挫伤视神经病变时血循环障碍。我们报告17例(19眼)检查结果。其中伤后20天内患者14例,PA主要表现为视盘弱荧光,盘周脉络膜充盈缺损,视网膜中央动脉及/(或)视网膜中央静脉充盈延迟。据此称为挫伤性急性缺血性视神经病变较合理,并强调早期综合治疗。 (中华眼底病杂志,1994,10:32-33)

    Release date:2016-09-02 06:34 Export PDF Favorites Scan
  • Retinal detachment due to ocular contusion

    Objective To find out about the characteristics and prognosis of retinal detachment due to ocular contusion.Methods The clinical data of 36 patients(36 eyes)with retinal detachment due to ocular contusion were retrospectively analyzed.Results There were 3 eyes(8.3%)with huge retinal hole(≥90°),4 eyes(11.1%)oral tear of ora serrata retinae,4 eyes(11.1%)with macular hole,3 eyes(8.3%)with tractive retinal detachment,and 22 eyes(61.2%)with retinal hole(lt;90°)at other positions(including temporal peripheral hole in 9,nasal peripheral hole in 5,and posterior polar hole in 8).Proliferative vitreoretinopathy(PVR)was found in a11 patients withConclusions Retinal detachment due to ocular contusion often go with PVR.The interval from contusion to retinal detachment varies from days to months.Visual prognosis can be good when retinal detachment is diagnosed and treated in time. (Chin J Ocul Fundus Dis,2004,20:1-66)

    Release date:2016-09-02 05:58 Export PDF Favorites Scan
  • Progress of Research on the Mechanism of Inflammatory Response in Pathogenesis of Lung Contusion

    Abstract: As the most common blunt thoracic injury, lung contusion may develop into acute lung injury, adult respiratory distress syndrome or ventilation associated pneumonia, which can cause a high mortality. However, the pathogenesis and pathophysiology of lung contusion is not well understood yet. Stress is laid by many researchers on inflammatory response in the pathogenesis of lung contusion. We review the potential role of inflammatory response in the pathogenesis and pathophysiological changes of lung contusion. Emphasis is put on studies of inflammatory cells, mediators, receptors, surfactant dysfunction, and the potential role of epithelial cell or neutrophil apoptosis. The animal models are essential to the study of lung contusion and the studies examining secondary injuries exacerbating lung contusion are also noted.

    Release date:2016-08-30 05:57 Export PDF Favorites Scan
  • 眼球钝挫伤眼底荧光血管造影所见

    对1985年7月至1991年12月期间的66例眼球钝挫伤行眼底荧光血管造影检查。重点描述了视网膜震荡伤、眼底出血、黄斑裂孔、脉络膜撕裂及视神经挫伤的造影所见,它们对临床诊断、发病机理 、治疗、预后均有一定的参考价值。 (中华眼底病杂志,1993,9:47-48)

    Release date:2016-09-02 06:35 Export PDF Favorites Scan
  • BLOOD RETINAL BARRIER CHANGES IN MILD AND SEVERE BLUNT OCULAR TRAUMA

    In vivo and in vitro tracer studies, e. g., fundus fluorescein angiography, fluorescein and lanthanum tracer procedures were carried out on mild and severe blunt ocular trauma in rabbits to investigate pathological changes of the blood retinal barrier. Noo difusion of the tracers was found in the retinal after mild blunt trauma. However, severe disorganization of the retinal pigment epithelial cells and breakdown of the outer blood retinal barrier with permeation of tracers in the interphotoreceptor space were evident after severe blunt trauma. These results suggest that contusional retinal edema is mainly due to disruption of cells in the outer retinal layer barrier may, in part, play a role in pathogenesis of the retinal edema. (Chin J Ocul Fundus Dis,1992,8:130-132)

    Release date:2016-09-02 06:36 Export PDF Favorites Scan
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