2023 年第 8 期 第 18 卷

胸腔镜微创手术和快速康复治疗严重胸部碾轧伤1例

Thoracoscopic minimally invasive surgery and rapid rehabilitation for severe chest crush injury: a case report

作者：周攀吴中权朱杰舒圣程玲玲

英文作者：Zhou Pan Wu Zhongquan Zhu Jie Shu Sheng Cheng Lingling

单位：武汉科技大学附属汉阳医院胸外科，武汉430050

英文单位：Department of Thoracic Surgery Hanyang Hospital Affiliated to Wuhan University of Science and Technology Wuhan 430050 China

关键词：严重胸部碾轧伤；胸腔镜微创手术；快速康复

英文关键词：Severechestcrushinjury;Thoracoscopicminimallyinvasivesurgery;Rapidrecovery

• 摘要：

• 本文介绍1例严重胸部碾轧伤患者。虽经气管插管、双侧胸腔闭式引流术等积极抢救治疗，但患者低氧血症、皮下气肿等仍得不到明显改善，考虑肺破裂或大气道损伤，急诊行胸腔镜下部分肺切除、肺修补合并双侧肋骨骨折切开复位内固定术。术后患者病情稳定，胸廓畸形得以纠正、结构稳定，肺复张良好。胸腔镜微创手术治疗严重胸部损伤，具有探查彻底、创伤小、恢复快、可替代部分传统手术的优点。临床实践过程中，可结合患者具体情况，运用现代胸外科围术期加速康复医学技术，促使患者更大获益。

• This article introduces a case of severe chest crush injury. Despite active rescue treatment such as tracheal intubation and bilateral thoracic closed drainage, the patient′s hypoxemia and subcutaneous emphysema were still not significantly improved. Considering lung rupture or atmospheric tract injury, partial pneumonectomy, lung repair combined with open reduction and internal fixation of bilateral rib fractures were performed under thoracoscope in emergency. After operation, the patient′s condition was stable, the thoracic deformity was corrected, the structure was stable, and the lung re-expansion was good. Thoracoscopic minimally invasive surgery for the treatment of severe chest injury has the advantages of thorough exploration, less trauma, rapid recovery, and can replace some traditional surgery. In the course of clinical practice, modern perioperative accelerated rehabilitation medical technology of thoracic surgery can be applied according to the specific conditions of patients to promote greater benefits for patients.