目的:分析四川汶川大地震胸部损伤患者影像学表现及其价值。方法:对地震发生后近2个月余陆续送至四川大学华西医院治疗,因地震致有胸部损伤史的155名伤员进行影像学分析总结。结果:在本组伤员中,胸廓骨折139例,胸膜损伤160例,肺损伤55例,纵隔损伤28例,肺部慢性感染39例,肺部肿块2例。其中部分伤员为多处复合性损伤。结论:影像学检查能准确、快速、有效地对地震胸部损伤患者进行判断,可为临床治疗方案起指导作用。
目的 总结胸部创伤流行病学及临床特征，为创伤的预防和救治提供科学依据。 方法 回顾性分析 2005～2015 年我院胸心外科连续收治 1 250 例胸部创伤患者的临床资料。根据患者伤情，分别采用无创性保守治疗、胸腔闭式引流术、开胸探查止血术、肋骨内固定术及其他胸部及心脏创伤的修补术。观察创伤患者致伤类型、创伤部位、治疗方式与临床预后以及 2012 年前后时间分布及其相关性。 结果 全组男 999 例（79.9%）、女 251 例（20.1%），平均年龄（44.0±17.7）岁。非穿透性损伤 885 例（70.8%），穿透性损伤 365 例（29.2%），死亡 8 例（0.64%）。肋骨骨折 766 例，骨折内固定手术干预占 16.1%（123/766），手术复位内固定患者平均住院时间明显短于保守治疗患者（9.55 dvs. 16.38 d，t=6.574，P=0.000）。2012 年后非穿透性损伤较 2012 年前有所升高（81.8%vs. 66.3%），而穿透性损伤较前明显下降（18.2%vs. 33.7%）（χ2=28.9，P=0.000）。2012 年前后创伤部位中肋骨骨折（P=0.000）、肺挫伤（P=0.000）、气胸（P=0.000）和胸腹联合伤（P=0.001）均发生了明显变化。 结论 2012 年是我院 10 年期间胸部创伤类型及创伤部位发生明显变化趋势的重要时间截点，对我院下一步胸部创伤救治侧重点转变带来了新的思考和考验。
The pediatric cadaver impact experiments were reconstructed using the validated finite element(FE) models of the 3-year-old and 6-year-old children. The effect of parameters, such as hammer size, material parameters and thorax anatomical structure characteristics, on the impact mechanical responses of 3-year-old and 6-year-old pediatric thorax was discussed by designing reasonable finite element simulation experiments. The research results showed that the variation of thorax contact peak force for 3-year-old group was far larger than that of 6-year-old group when the child was impacted by hammers with different size, which meant that 3-year-old child was more sensitive to hammer size. The mechanical properties of thoracic organs had little influence on the thorax injury because of the small difference between 3-year-old and 6-year-old child in this research. During the impact, rib deformation led to different impact location and deformation of internal organs because the 3-year-old and 6-year-old children had different geometrical anatomical structures, such as different size of internal organs. Therefore, the injury of internal organs in the two groups was obviously different. It is of great significance to develop children finite element models with high biofidelity according to its real anatomical structures.
发生在我国汶川的5·12特大地震为里氏8.0级，造成大量人员伤亡及财产损失。据统计，截至2008年6月2日12时，此次大地震全国共有69 107人遇难，373 577人受伤，18 230人失踪。地震发生后，国家立即动员大量人力搜救受伤人员，使部分被掩埋人员及时从倒塌废墟中挖掘出来。同时，全国卫生系统紧急动员，对这些被抢救出的伤员进行了救治。据卫生部统计，到目前为止，因地震伤病住院治疗合计92,973人，已出院68 565人，仍有11 832人住院，共救治伤员583 891人次（http://scnews.newssc.org/system/2008/06/02/010871823.shtml）。分析既往地震及其他自然灾害中病人的伤害的情况及救治经验，总结此次地震中病人受伤情况及救治过程中的得失，对我们应对以后的地震及其他自然灾害有一定帮助。