钝性胸外伤后肋骨骨折的定位及其与创伤性血气胸的关系的研究

S. Akboğa, Y. Akkas
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引用次数: 0

摘要

背景:胸外伤占外伤死亡的20-25%。在年轻人中,最常见的死因是胸部外伤。对钝性胸外伤的调查显示,在年轻人中最常见的原因是车内交通事故(IVMTA),而在老年人中排名第一的是跌倒。研究钝性胸外伤导致的肋骨骨折定位与血胸、气胸或血气胸之间的关系,并比较结果。材料和方法:2018年11月至2019年11月,回顾性评估了81例钝性胸外伤和肋骨骨折患者的胸部计算机断层图像。肋骨骨折根据骨折部位分为上、中、下三个胸段。结果:肋骨骨折以胸椎中段骨折最常见,57例(70.3%)。平均住院时间5.4天(范围1 ~ 24天)。其他病理表现为血胸20例(24.7%),气胸16例(19.8%),气胸5例(6.2%)。在发生肋骨骨折的胸段中,上胸段最常发生血胸和气胸,分别有11例(32.3%)和8例(23.5%)。结论:钝性胸外伤后肋骨骨折最常见的部位是胸椎上中段。在上胸段,急诊胸外科并发症,如血胸/气胸,在创伤后肋骨骨折的早期,与其他节段相比,更常见。钝性胸外伤导致的肋骨骨折的节段性定位在发病率方面是至关重要的,决定是采用侵入性治疗还是保守性治疗取决于这一信息。
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Localization of rib fractures following blunt thorax trauma and investigating the relationship between these and traumatic hemopneumothorax
  Background: Thorax traumas form 20-25% of deaths resulting from trauma. In the young population, the most common reason for death resulting from trauma is thorax trauma. The investigation of blunt thorax trauma reveals that the most common reason in the young population is 'in-vehicle motor traffic accidents (IVMTA), while falls take the 1st place in the geriatric population. The relationship between the localization of rib fractures developing due to blunt thorax trauma and the resultant hemothorax, pneumothorax, or hemopneumothorax investigated, and results compared. Material and Method: Between the dates November 2018 and November 2019, thoracic computerized tomography views of a total of 81 patients who applied with blunt thorax trauma and rib fractures evaluated retrospectively. Rib fractures were divided into three as upper, middle and lower thoracic segments according to their localization. Results: The most common localization for rib fracture was the middle thoracic segment with 57 (70.3%) patients. The mean hospitalization period was 5.4 (range: 1-24) days. Additional pathological findings were hemothorax, pneumothorax, and hemopneumothorax in 20 (24.7%), 16 (19.8%), and 5 (6.2%) patients, respectively. Among thoracic segments where rib fractures encountered, the upper thoracic segment most commonly led to hemothorax and pneumothorax with 11 (32.3%) and 8 (23.5%) patients, respectively. Conclusion: The most common localization of rib fractures following blunt thorax trauma is the upper and middle thoracic segment. In the upper thoracic segment, emergency thorax surgery complications like hemothorax/pneumothorax follow posttraumatic rib fractures in the earlier term and are more common when compared to other segments. The segmental localization of rib fractures developing due to blunt thorax trauma is essential in terms of morbidities, and the decision of invasive or conservative treatment depends on this information.
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