Thoracic_Trauma presentation课件.ppt

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Thoracic Trauma Department of chest surgery Affiliated hospital of NBU Leon Classification and pathophysiology closed trauma 1) soft tissue bruise 2) rib fracture 3) hemothorax 4) pneumothorax 5) hemopneumothorax 6) hemopericardium Classification and pathophysiology open trauma Pneumothorax hemothorax effect the function of respiration and circulation Classification and pathophysiology thoracic-abdominal injury It is one of the conditions which requiring urgent thoracotomy It’s leading to diaphragmatic hernia Hemorrhagic shock Clinic manifestation 1.chest pain: the most chief symptom 2.dyspnea 3. dysphoria 4. blood sputum or hemoptysis 5. shock serious bleeding of intrathorax a large quantity of air in thoracic cavity (especially tension pneumothorax) hemopericardium local signs chest wall bruise paradoxical motion subcutaneous emphysema shift of trachea and heart percussion: tympanic resonance or dull resonance auscultation: distant breath sound or absent breath sound Diagnosis injured history and manifestation thoracentesis X-ray or CT Treatment stop (relieve) pain establishing and remaining a clear airway fixation chest wall debridement and suture of wound thoracentesis and thoracic close drainage thoracotomy for active bleeding use antibiotic to preventing infection Conditions requiring urgent thoracotomy continued intrapleural bleeding massive air leak acute or rapidly recurring pericardial tamponade thoraco-abdominal injury massive foreign matter retained in thorax * * * * * *

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