Abstract
Trauma to the thorax represents a significant portion of injuries seen in an inner-city emergency room. Although most of these patients may be sucessfully managed without thoracotomy, a certain percentage requires operative intervention either immediately or within several hours. 126 records of patients who had early thoracotomy for chest trauma from March 1986, to June 1997, in the Department of Thoracic and Cardiovascular Surgery in Masan Samsung General Hospital were reviewed. There were 96 males and 30 females whose ages ranged from 4 to 72 years, with a mean age of 32.8 years. The modes of injury were as follows : stab wounds, 55 cases(44%), blunt trauma, 70 cases(55%), and gunshot wound, 1 case(1%). Immediate operation was performed in 105 cases(84%) and delayed operation in 21 cases(16%). Indications that operation was necessary were hemorraging and shock in 66 cases(52%), cardiac tamponade in 27 cases(21%), and rupture of the diaphragm in 33 cases(27%). Most of these patients were sucessfully treated but 21 cases were resulted in death. The mortality rate was 16.6% and common causes of death were irreversible shock and hypoxia.
흉부외상은 응급실에서 중요한 부분을 차지하고 있다 대부분의 외상은 보존적인 요법으로 치료가 되나, 소수의환자에서는 조기소생술후에 응급 수술이 시행되어져야 한다. 1986년 3월부터 1997년 6월 까지 흉부외상으로 응급수술한 126례을 대상으로 보고하고자 한다. 남자가 96례 여자가 30례 이고, 나이의 분포는 4세에서 72세며 평균 연령은 32.8세이였다. 수상의 원인은 자상 55례(44%), 둔상 70례(55%), 총상 1례(1%)이였고, 조기수술 105례(83%), 후기 수술 21례(17%)이였다. 수술 적응증은 혈흉 및 쇼크 66례(52%), 심압전 27례(21%), 횡격막 파열 33례(27%)을 수술하였다. 대부분의 환자에서는 성공적인 치료가 되었으나, 21례에서 사망하였고, 사망율은 16.6%였다 그리고 사망원인은 불가역적인 쇼크와 저산소증이 흔한 원인이였다.