Acil serviste penetran göğüs travması: 76 hastanın analizi

Amaç: Travma, genç nüfusun ba?ta gelen ölüm nedenidir. Travmaya ba?ly ölümlerin %25inden torakstravmasy sorumludur ve di?er %25inde mortaliteye katky sa?lamaktadyr. Bu çaly?mada acil servise penetrangö?üs travmasy ile ba?vuran hastalaryn analizi yapylmy?tyr. Gereç ve Yöntem: 2010 yyly içerisinde acil serviseba?vuran 76 penetran gö?üs travmaly hastanyn ya?lary, cinsiyetleri, travma nedenleri, ba?vuru zamanlary,torasik patolojileri, tany yöntemleri ve sonuçlary, uygulanan tedaviler, yaty? bilgileri ve e?lik eden yaralanmalaranaliz edildi. 76 hasta çaly?maya dâhil edildi. Hastalaryn ya? ortalamasy 31.4 idi (18-63 arasy) ve %93.4üerkekti (n:71), E/K orany 14.2 idi. Bulgular: Penetran gö?üs travmasynda en syk neden delici-kesici aletyaralanmasy (59 hasta, %77.6), ikinci en syk neden ise ate?li silah yaralanmasyydy (14 hasta, %18.4). Gö?üstravmasyna en syk e?lik ekstremite yaralanmalary (19 hasta, %24) e?lik ediyordu. Hastalaryn 24'ü (%31.5)konservatif olarak izlendi; 40 (%52.6) hastaya gö?üs tüpü uygulandy. Sonuç: Penetran gö?üs travmalary ensyk delici-kesici alet yaralanmalary ile gerçekle?ir ve ço?unlukla konservatif yöntemlerle veya tüp torakostomiile tedavi edilebilir.

The penetrating thoracic trauma in the emergency department: Retrospective analysis of 76 patients

Objective: Trauma is the most frequent cause of death among the young population. Thoracic trauma is responsible for 25% of all deaths due to trauma, and contributes to mortality among the other 25% of deaths due to trauma. In this study, analysis of 76 patients admitted to the emergency department with penetrating chest trauma was performed. Materials and Methods: 76 patients admitted to the emergency department with penetrating chest trauma in 2010 were included to the study. Age, gender, causes of trauma, admission times, thoracic pathologies, diagnostic methods and their results, medical managements, hospitalization information and concomitant injuries were analyzed. 76 patients were included in the study. The mean age was 31.4 , 93.4% of patients were male (n=71), F/M ratio was 14.2. Results: The most common cause of penetrating trauma was stab injury (59 patients, 77.6%), the second most common cause was gunshot injury (14 patients, 18.4%). The most common pathology associated with chest trauma were extremity injury (19 people, 24%). 24 patients (31.5%) were followed conservatively; tube thoracostomy were performed to 40 (52.6%) of the patients. Conclusions: The most frequent cause of penetrating chest trauma is stab injury, it can be treated frequently with conservative management and tube thoracostomy.

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  • 1. LoCicero J, 3rd, Mattox KL. Epidemiology of chest trauma. Surg Clin North Am. 1989 Feb;69(1):15-9.
  • 2. Özçelik C, Balcy AE, Eren ?, Ülkü R, Doblan M, Eren N. Toraks travmalary (10 yyllyk deneyim). Ulusal Travma Dergisi. 2000;6:44-9.
  • 3. VanNata TL, Morris JA. Injury scoring and trauma ourcomes. In: Mattox KL, Feliciano DV, Moore EE, editors. Trauma. New York: NY:McGraw Hill Companies; 2000. p. 69-80.
  • 4. Hoyert DL, Heron MP, Murphy SL, Kung HC. Deaths: final data for 2003. Natl Vital Stat Rep. 2006 Apr 19;54(13):1-120.
  • 5. Trupka A, Waydhas C, Hallfeldt KK, Nast-Kolb D, Pfeifer KJ, Schweiberer L. Value of thoracic computed tomography in the first assessment of severely injured patients with blunt chest trauma: results of a prospective study. J Trauma. 1997 Sep;43(3):405-11; discussion 11-2.
  • 6. Robison PD, Harman PK, Trinkle JK, Grover FL. Management of penetrating lung injuries in civilian practice. J Thorac Cardiovasc Surg. 1988 Feb;95(2):184-90.
  • 7. Tekinbas C, Eroglu A, Kurkcuoglu IC, Turkyilmaz A, Yekeler E, Karaoglanoglu N. [Chest trauma: analysis of 592 cases]. Ulus Travma Acil Cerrahi Derg. 2003 Oct;9(4):275-80.
  • 8. Guitron G, Huffman LC. Blunt and penetrating injuries of the chest wall, pleura, and lungs. In: Shields TW, editor. General Thoracic Surgery. Fifth ed. Philadelphia: Williams and Wilkins; 2009. p. 891-903.
  • 9. Reed RL. Lung Infections and Trauma. In: Norton JA, Bollinger RR, Chang AE, Lowry SF, Mulvihill SJ, Pass HI, Thompson RW, eds. Surgery: Basic Science and Clinical Evidence. New York, NY: Springer-Verlag; 2001:1217-30.
  • 10. Soysal Ö. Künt gö?üs travmalary. In: Yüksel M, Göksel NG, editors. Gö?üs cerrahisi. 1st ed. Ystanbul: Bilmedya Grup; 2011. p. 447-64.
  • 11. Rubikas R. Diaphragmatic injuries. Eur J Cardiothorac Surg. 2001 Jul;20(1):53-7.
  • 12. Rosati C. Acute traumatic injury of the diaphragm. Chest Surg Clin N Am. 1998 May;8(2):371-9.
  • 13. Shah R, Sabanathan S, Mearns AJ, Choudhury AK. Traumatic rupture of diaphragm. Ann Thorac Surg. 1995 Nov;60(5):1444-9.
  • 14. Reber PU, Schmied B, Seiler CA, Baer HU, Patel AG, Buchler MW. Missed diaphragmatic injuries and their long-term sequelae. J Trauma. 1998 Jan;44(1):183-8.
Süleyman Demirel Üniversitesi Tıp Fakültesi Dergisi-Cover
  • ISSN: 1300-7416
  • Yayın Aralığı: Yılda 4 Sayı
  • Başlangıç: 1994
  • Yayıncı: SDÜ Basımevi / Isparta