上海交通大学学报（医学版）

›› 2010, Vol. 30 ›› Issue (12): 1486-.doi: 10.3969/j.issn.1674-8115.2010.12.009

• 专题报道（创伤医学） • 上一篇    下一篇

急诊手术内固定对创伤性连枷胸患者血流动力学的影响

滕继平, 倪 达, 程佑爽, 程云阁, 潘荣华, 朱智军   

  1. 上海交通大学 医学院附属第三人民医院胸心外科 创伤医学研究所, 上海 201900
  • 出版日期:2010-12-25 发布日期:2010-12-31
  • 作者简介:滕继平(1979—), 男, 主治医师, 硕士；电子信箱: tengjiping2000@yahoo.com.cn。
  • 基金资助:

    上海交通大学医学院附属第三人民医院基金(syz08-13)和上海市教委优秀青年教师科研专项基金(jdy09068)

Effects of emergency surgical internal fixation management on hemodynamics in patients with traumatic flail chest

TENG Ji-ping, NI Da, CHENG You-shuang, CHENG Yun-ge, PAN Rong-hua, ZHU Zhi-jun   

  1. Department of Cardiothoracic Surgery, The Third People's Hospital, Institute of Traumatic Medicine, Shanghai Jiaotong University School of Medicine, Shanghai 201900, China
  • Online:2010-12-25 Published:2010-12-31
  • Supported by:

    Foundation of The Third People's Hospital, Shanghai Jiaotong University School of Medicine, syz08-13；Foundation of Shanghai Education Committee for Excellent Young Teachers, jdy09068

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摘要：

目的 观察急诊手术内固定治疗对创伤性连枷胸患者血流动力学的影响。方法 34例接受急诊手术内固定治疗的创伤性连枷胸患者，监测并比较麻醉诱导前、麻醉后术前、术后即刻、术后4 h和术后24 h患者心率（HR）以及心排量（CO）、肺毛细血管楔压（PCWP）、平均动脉压（MAP）和中心静脉压(CVP)等血流动力学指标的变化。结果 与麻醉诱导前和麻醉后术前比较，术后即刻、术后4 h和术后24 h患者HR和CVP显著下降(P<0.05)，CO、PCWP和MAP显著增加(P<0.05)。结论 急诊手术内固定治疗可改善创伤性连枷胸患者的血流动力学状况，具有一定的近期疗效。

关键词: 连枷胸, 血流动力, 肋骨骨折, 内固定

Abstract:

Objective To investigate the effects of emergency surgical internal fixation on hemodynamics in patients with traumatic flail chest. Methods A total of 34 patients with traumatic flail chest managed by emergency surgical internal fixation were selected. The parameters of heart rate (HR), cardiac output (CO), pulmonary capillary wedge pressure (PCWP), mean arterial pressure (MAP) and central venous pressure (CVP) at the time points of before anesthesia induction, before operation after anesthesia, immediately after operation, 4 h after operation and 24 h after operation were monitored and compared. Results Compared with those at the time points of before anesthesia induction and before operation after anesthesia, HR and CVP significantly decreased (P<0.05), and CO, PCWP and MAP significantly increased at the time points of immediately after operation, 4 h after operation and 24 h after operation (P<0.05). Conclusion Emergency surgical internal fixation may improve the hemodynamics of traumatic flail chest, and has some short-term therapeutic effect on flail chest.

Key words: flail chest, hemodynamics, fracture of rib, internal fixation