医大二院胸外科.ppt

Thoracic Trauma
医大二院胸外科
Classification and pathophysiology
closed trauma
1) soft tissue bruise
2) rib fracture
3) hemothorax
4) pneumothorax
5) hemopneumothorax
6) hemopericardium
7) traumatic asphyxia
8) blast injury of lung
open trauma
Pneumothorax
hemothorax
effect of the function of respiration and circulation
thoracic-abdominal injury
Clinic manifestation
chest pain: the most chief symptom
dyspnea
1) chest pain
2) block of trachea
3) pneumochysis
4) flail chest
3. breathlessness, orthopnea, dysphoria4. blood sputum or hemoptysis
5. shock
serious bleeding of intrathorax
a large quantity of air in thoracic cavity (especially tension pneumothorax)
hemopericardium
6. local signs
chest wall bruise
paradoxical motion
subcutaneous emphysema
tenderness
shift of trachea and heart
percussion: tympanic resonance or dull resonance
auscultation: distant breath sound or absent breath sound
Diagnosis
injured history and manifestation
pleurocentesis
roentgenogram
Treatment
stop (relieve) pain
fixation chest wall
debridement and suture of wound
thoracentesis and tube thoracostomy
thoracotomy for active bleeding
use antibiotic to preventing infection