[摘要] 目的 探讨影响胸部钝伤住院患者治疗方式的因素，对胸部X线片判读的差异进行分析，作为改进处置胸部钝伤患者的依据及参考。方法 采用回顾性研究方法，收集2004~2006年因胸部钝伤或其外伤合并胸部钝伤，经急诊评估损伤严重指数(ISS)≤15，且对胸部钝伤暂采保守疗法的住院患者共96例(男76例，女20例)。对患者年龄、既往史、ISS、胸部X线片判读等对治疗方式的影响与关系分为因病情需要改采用手术治疗组和继续采用保守治疗组来比较分析。结果 两组在平均年龄、性別、ISS的统计上无差別。影响患者住院期间采用手术治疗的因素有年龄>65岁(OR,3.14;95% CI，1.21~8.12;P<0.05)；过去有心肺疾病病史(OR,2.85，95% CI，1.24~6.52，P<0.05)；第一次的胸部X线片判读有血胸(OR,3.97;95% CI，1.43~10.98;P=0.015)。结论 年龄>65岁，有心肺病史、第一次的胸部X线片判读有血胸是胸部钝伤患者在住院后改采用手术治疗的危险因子。有必要住院后追踪胸部X线片。

    [关键词] 胸部钝伤；损伤严重指数；胸部X线片

    Factors and chest X-ray findings influencing treatment option for blunt chest trauma patients

    LIU Ying-xun,YU Bang-xu，Song Lei,et al.ICU Department,the Chengyang Hospital,Qingdao 266109,China

    [Abstract] Objective To identify the factors and chest X-ray findings influencing the treatment option for blunt chest trauma patients with Injury Severity Score (ISS)≤15 during admission who initially received conservative medical treatment.Methods Medical records and chest X-rays were retrospectively reviewed of 96 blunt chest trauma patients,76 were male and 20 female who received conservative medical treatment initially with Injury Severity Score (ISS)≤15 from 2004 to 2006.Forty-four patients received invasive surgical treatment and fifty-two patients received conservative medical treatment after admission.Demographic characteristics,underlying cardio-pulmonary disease,clinical manifestations,ISS,chest X-ray findings and treatment options were evaluated and compared between the two groups.Results The two groups had similar mean age (56.3 vs 48.5),mean ISS (6.82 vs 5.77) and mean number of rib fractures (1.82 vs 2.42).In elderly patients (>65 years old),this occurred in 36.4% of surgical group patients versus 15.3% of medical group patients (OR,3.14 ......