TORAKS TRAVMALARI (10 YILLIK DENEYÝM)

Amaç: Toraks travmalarýný içeren geniþ bir serinin sonuçlarýný incelemek. Yöntem: Dicle Üniversitesi Týp Fakültesi Göðüs Kalp ve Damar Cerrahisi Kliniði'nde 1989 1998 yýllarý arasýnda toraks travmalý 1642 olgu retrospektif olarak incelendi. Olgularýn bir kýsmý Yaralanma Aðýrlýk Skoru (YAS) ve akciðer perfüzyon ve ventilasyon sintigrafileriyle izlendi. Sonuçlar: Toplam 1642 hastadan 917'si (% 56) künt, 725'i (% 44) penetran yaralanmaydý. Yandaþ yaralanma 432 hastada vardý (% 26.3). Morbidite oraný 515 hastayla % 31.4 ve en sýk morbidite nedeni intratorasik hemotomdu. Hastalarýn 1509'una (% 92) konservatif tedavi verildi, 133'üne torakotomi yapýldý (% 8.1). Torakotomilerin 56'sý acil (% 3.4), 77si (% 4.7) geç torakotomiydi. Mortalite %7 (116/1642) olup, künt travma grubunda % 9.5 (87/917), penetran travma grubunda % 4 (29/725) bulundu. YAS 25'in üzerinde olanlarda ve künt travmalarda mortalite daha yüksekti. En sýk mortalite nedeni Eriþkinin Sýkýntýlý Solunum Sendromuydu. Torakotomi mortalitesi % 25.5 (34/133) idi ve bunun % 15 (20 hasta)'ini acil, % 10.5 (14 hasta)'ini geç torakotomi oluþturmaktaydý. Torakotomi yapýlmayan grubun mortalitesi % 5.1 (78/1509) idi. Hafif travma olgularýnda ventilasyon/perfüzyon bozulmuþtu ve ortalama düzelme süresi 7-10 gündü.

THORACIC TRAUMA (TEN YEARS EXPERIENCE)

Object: To examine a broad serial which includes thoracic trauma. Method: Between 1989 and 1998, 1642 patients with thoracic trauma were studied retrospectively in Thoracic and Cardiovascular Surgery Department of Dicle University School of Medicine. Some cases were followed with Injury Severity Score (ISS) and lung perfusion and ventilation scans. Results: The patients with penetran trauma were 917(% 56), blunt trauma were 725 (% 44) of total 1642. Injuries associated with thoracic trauma were present in 532 patients (% 26.3). Morbidity rate was % 31.4 and the most frequent cause was clotted hemothorax. Conservative therapy was given to 1509 patients (% 92). Thoracotomy was performed in 133 patients (% 8.1). Fifty-six thoracotomy was immediate (% 3.4) and 77 was late (% 4.7). Mortality rate was %7(116/1642), % 9.5 (87/917) in blunt trauma group, % 4 (29/725) in penetran trauma group. If ISS > 25 and in blunt trauma, mortality was significantly higher (p<0.05). The most frequent mortality cause was ARDS. Thoracotomy mortality was % 25.5 (34/133) and % 15 (20 patients) in immediate, % 10.5 (14 patients) in late thoracotomy group. In non - thoracotomy group, mortality was % 5. / (78/1509). Ventilation/perfusion scans was broken down and mean recovery time was 7-10 days in mild trauma group.