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胸部戰傷의 統計的 觀察

Review and Analysis of Chest Injury During the Korean Conflict

대한외과학회지 1962년 4권 8호 p.569 ~ 576
朴容喆, 劉承華,
소속 상세정보
朴容喆 (  ) - 梨花女子大學校 醫科大學 外科學敎室
劉承華 (  ) - 梨花女子大學校 醫科大學 外科學敎室

Abstract


300 cases of chest injury during the Korean conflict are reviewed and analyzed. Of these 300 cases, 86 cases had major injury and required either immediate surgery or conservative treatment. Most of them were elosed chest injuries by gun-shot or shell-fragments.
Most of the chest inguries were caused by shell-fragments(58%) and gun-shots(32%). Classification According to site of injuries are 46.69% in the right chest and 22.27% in the left chest.
56 cases or 65.11 % had elosed chest wounds and 25 cases or 29.06% had penetrating wounds of the chest. 5lcases or 59.8% had injury to the intrathoracic viscerae, and 52 cases or 60.45% developed hemothorax; 29.06% or 25 cases had pneumothorax.
In 18 cases or 20.93% the wound of the chest wall was treated by adeouate debridement and primary closure. Three post-operative wound infections occurred. 40 cases or 46.51 % with minimal or moderate hemothorax and pnemo-hemothorax, were treated by thoracentesis or closed drainage. 15 cases or 17.43% required early thoracotomy for thoracic injuries. Among the 6 cases of cardiec tamponade, 4 cases were treated by pericardiocentesis, One case was operated upon promptly because of rapidly recurring tamponade. One case required no treatment. In spite of early adequate treatment, the mertality rate from thoraco-abdominal injuries uns much higher than that from abdominal injuries alone. Our mortality from 86 cases was 9.3%.
Preoperative correction of altered intrathoracic physiology is important before surgery for thoraco-abdominal injury. Shock is usually more marked in thoraco-abdominal injuries than thoracic injury alone. We are of the opinion that in case of thoraco-abdominal injuries, thoracic leEions should be corrected first before the exploratory laparotomy except for the case in which a concurrent thoracoabdominal procedure is needed
We consider our mortality rate was little higher that which appeares in the literature. This could be improved by repeated physical examinationsduring first 24 hour and ancillary treatment.

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