흉부 외상에서 폐좌상(Pulmonary contusion)과 외상성 폐낭종 (Traumatic lung cyst)을 동반한 환자의 임상경과 및 예후 예측 인자

김용환; 현성열; 김진주; 김정권; 임용수; 양혁준; 이미진

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자료유형: 학술저널

저자정보: 김용환 (가천의과학대학교 길병원 응급의학과) 현성열 (가천의과학대학교 길병원 흉부외과) 김진주 (가천의과학대학교 길병원 응급의학과) 김정권 (가천의과학대학교 길병원 응급의학과) 임용수 (가천의과학대학교 길병원 응급의학과) 양혁준 (가천의과학대학교 길병원 응급의학과) 이미진 (건양대학교 의과대학 응급의학교실)

저널정보: 대한외상학회 Journal of trauma and injury : JTI Journal of trauma and injury : JTI 제21권 제2호

발행연도: 2008.1

수록면: 100 - 107 (8page)

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Purpose: A traumatic lung cyst (TLC) is a rare complication and is usually detected with a pulmonary contusion. This study attempted to identify the prognostic factors and the clinical characteristics for pulmonary contusion with TLCs. Methods: We retrospectively reviewed the medical records and chest CT findings of 71 TLC patients who visited our hospital from January 2006 to December 2007. Patients were assessed for any clinical characteristics. We evaluated significant differences between the survival and the death groups for patients with a traumatic lung cyst. Results: The male-to-female ratio of patients with TLCs was 54:17, and the mean age of the patients was $37.70{\pm}19.78years$ with 36.6% of the patients being under 30 years fo age. The cause of blunt thoracic trauma was mainly pedestrian traffic accidents (26.8%) and falls (25.4%). Associated conditions included pulmonary contusion in 68 patients (95.7%), hemopneumothorax in 63 patients (88.7%), and rib fracture in 52 patitents (73.2%). There was no consistent relationship between the number of TLCs and the pulmonary contusion score. The overall mortality rate of TLC patients was 26.8%. Death correlated with a need for ventilatory assistance, mean arterial pressure, worst mean arterial pressure in 24 hours, initial pH and base excess, worst pH and base excess in 24 hours, refractory shock, initial GCS score, and pulmonary contusion score. Conclusion: The presence of the aforementioned predictors indicate serious injury, which is the main determinant of the outcome for thoracic injuries with TLCs.

#Thoracic injuries #Pulmonary contusion #Pulmonary pseudocyst #Prognosis #Mortality

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