胸部外伤ppt课件_16.ppt

生活家饮食保健孕期选择食用油的学问邢台市第四病院罕见护理应急预案猪气喘病综合防制技术动物营养系列理想蛋白与氨基酸模式的研究进展皮肤病的诊断包括病史体格检查和必要的实验室检查我国有关食物添加剂营养强化剂食物新资本的治理律例与标准 胸外伤 Incidence and mortality发生率和死亡率: Chest trauma accounts for 8% occurrences of total traumatic cases, more than 25% of death caused by trauma. Incidence proportion Mortality proportion 胸外伤概况 胸外伤病因 Penetrating trauma贯穿伤 Blunt trauma 钝挫伤 车祸伤 坠落伤 挤压伤 刀刺伤 火器伤 Results from kinetic energy forces Blast（爆破伤） Pressure wave causes tissue disruption Tear blood vessels disrupt alveolar tissue Disruption of tracheobronchial tree Traumatic diaphragm rupture Crush (Compression)（挤压伤） Body is compressed between an object and a hard surface Direct injury of chest wall and internal structures Deceleration（减速伤） Body in motion strikes a fixed object Blunt trauma to chest wall Internal structures continue in motion Ligamentum Arteriosum shears aorta Blunt Trauma 压力波造成组织破坏撕裂血管，破坏肺泡组织破坏气管支气管树 创伤性膈肌破裂  胸外伤病理生理 Low Energy Arrows, knives, handguns Injury caused by direct contact and cavitation High Energy Military, hunting rifles high powered hand guns Extensive injury due to high pressure cavitation Penetrating Trauma 穿透伤合并损伤 Closed pneumothorax Open pneumothorax Tension pneumothorax Pneumomediastinum Hemothorax Hemopneumothorax Laceration of vascular structures 闭合性气胸开放性气胸张力性气胸气肿血胸血气胸血管损伤 Tracheobronchial tree lacerations Esophageal lacerations Penetrating cardiac injuries Pericardial tamponade Spinal cord injuries Diaphragm trauma Intra-abdominal penetration with associated organ injury 气管支气管树裂伤食管裂伤穿透性心脏损伤心包填塞脊髓损伤膈肌损伤伤腹腔内脏器损伤 穿透伤合并损伤 胸外伤详细分类及病理生理改变 Chest wall contusions or hematomas  胸壁挫伤或血肿 Rib fractures 肋骨骨折Flail chest 连枷胸Sternal fractures 胸骨骨折Fractures of the shoulder girdle 肩胛带骨折 Injuries to the chest wall Contusion Dyspnea Pain on breathing Hypoventilation Crepitus Paradoxical chest wall motion 呼吸困难呼吸疼痛通气不足捻发音胸壁反常运动 Rib Fractures 50% of significant chest trauma cases due to blunt trau