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《Chongqing Medicine》 2007-22
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Clinical analysis of multiple injuries associated with rib fracture in 687 cases

HU Ping,GAO Jin-mou,WEI Gong-bin,et al.(Department of Traumatology,Chongqing Emergency Medical Center,Chongqing 400014,China)  
Objective To probe clinical characteristics and management of polytrauma associated with rib fractures.Methods A total of 687 cases of polytrauma with multiple ribs fractures from 1987 to 2004 treated in our department were analyzed retrospectively.Results 327 cases underwent pleural drainage.Mediastinal drainage and decompression were performed in 6 cases.Tracheotomy was done in 42 cases,and 66 cases underwent exploratory laparotomy(splenectomy or Splenorrhaphy in 33 cases,hepatic repair in 17 cases,Pancreatectomy of the tail in 2 cases,nephrectomy in 5 cases,partial gastric or intestinal resection or anastomosis in 22 cases,diaphragm repair in 12 cases,bladder repair or fistulization in 7 cases,iliac artery ligation in 2 cases),arteriographic embolization of liver,spleen,kidney and internal iliac artery were done in 6 cases,exploratory thoracotomy was performed in 13 cases,(among whom,6 cases underwent partial pneumonectomy or pneumonorrhaphy,and 3 cases underwent pericardium decompression,as well as 7 cases underwent intercostal artery or internal mammary artery ligation).Internal fixation was done for sternal or costal fractures in 12 cases,ribs traction in 36 cases,spinal operation in 16 cases,internal fixation for pelvic fractures in 6 cases,internal fixations for clavicle spine or limb fracture in 98 cases,and craniotomy in 28 cases.In this group,24 cases died(3.49%).Among them,10 died of acute hemorrhagic shock,9 severe pulmonary contusion,pulmonary infection or ARDS,and 5 brain injury.Conclusion The key of successful saving is to conduct emergent procedures while they are in "golden time" for traumatic patients.Prevention and treatment for pulmonary contusion,infection and/or ARDS during periopreative phase are effective measures.
【CateGory Index】: R641;R683.1
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1 GAO Jin-mou, HU Ping, TIAN Xian-yang ,et al. (Department of Traumatology,Chongqing Emergency Medical Center,Chongqing 400014,China);Management of multiple traumas:experience in 2 368 cases[J];Journal of Traumatic Surgery;2004-06
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【Co-references】
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1 FEI Jun,YU Hong-jun,HUANG Xian-kai,et al. (Department of Trauma,Daping Hospital,Third Military Medical University,Chongqing 400042,China);Form and significance of internal fixation in flail chest operation[J];Journal of Traumatic Surgery;2003-04
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