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| Crnjac A. Med Mes 2006; 2:227-31. |
Nestabilni prsni koš - konzervativna terapija ali operativna fiksacija?Nestabilni prsni koš, ki nastane zaradi prekinjene kostne kontinuitete prsnega koša, zahteva zaradi kompleksnosti patofizioloških dogajanj hitro in pravilno diagnostiko ter ustrezno zdravljenje. Osnovno patofiziološko dogajanje pri nestabilnem prsnem košu je dihalna stiska, ki se razvije zaradi obtolčenin pljuč in paradoksalnega gibanja prizadetega dela stene prsnega koša. Zdravljenje mora biti usmerjeno predvsem v izboljšanje in podporo dihalni funkciji ter obsega agresivno analgezijo, respiratorno fizioterapijo in selektivno umetno ventilacijo. Mnenja o operativni učvrstitvi nestabilnega prsnega koša so še vedno deljena, saj z njo ni mogoče pomembneje zmanjšati niti kasnih posledic. |
Flail chest - conservative therapy or operative fixation?The flail chest occurs after disruption of the skeletal continuity of chest wall and demands because of its pathophysiological complexity rapid and accurate diagnosis and treatment. Basic pathophysiological mechanism of the flail chest is respiratory distress, which is provoked by pulmonary contusions and paradoxical chest wall motion. The treatment should be pointed to improvement and support of respiratory functions and include aggresive paincontrol, pulmonary physiotherapy and selective mechanical ventilation. Views about operative fixation of the flail chest are still controversial. Neither mortality rate neither long-term disability are improved after operative fixation. |
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