| Abstract | Trauma prsnog koša predstavlja potencijalno smrtonosnu ozljedu s obzirom na vitalne organe koji su anatomski smješteni u njemu. Od velike je važnosti rana intervencija kako bi se povećala stopa preživljavanja. Ozljede prsnog koša zauzimaju drugo mjesto po uzroku smrtnosti kod traumatskog ozljeđivanja. Od značajne je važnosti poznavanje anatomije prsnog koša kako bi prepoznali vrstu i veličinu ozljede.
Ozljede prsnog koša mogu biti otvorene ili zatvorene. Prijelom rebara najčešća je traumatska ozljeda prsnog koša. Klinička slika ovisi o broju ozlijeđenih rebara, komplikacijama i popratnim ozljedama. Komplikacije prijeloma rebara su nestabilni prsni koš, pneumotoraks, hematotoraks i njihova kombinacija, subkutani emfizem, ruptura dijafragme, ruptura slezene i jetre, ozljeda traheje, ozljeda bronha, te velikih krvnih žila. Liječenje ovisi o težini ozljede. Konzervativne mjere: adekvatna analgezija, oksigenoterapija, vježbe disanja i iskašljavanja, mjere sprečavanja nastanka infekcija pluća. Kod težih ozljeda i komplikacija potrebno je kirurško zbrinjavanje ozljeda.
Tema rada je analizirati i prikazati učestalost komplikacija prijeloma rebara u Kliničkom bolničkom centru Rijeka, na Odjelu za torakalnu kirurgiju u periodu od 01.01.2018. do 01.05.2019. Uspoređene su učestalosti komplikacija prijeloma rebara kod bolesnika koji u redovnoj terapiji uzimaju antikoagulantne i antiagregacijske lijekove sa bolesnicima koji ne uzimaju iste.
Istraživanjem je obuhvaćeno 120 bolesnika, 70.8 % su činili muškarci, a 29.2 % žene. Najveći postotak bolesnika imalo je slomljeno tri ili četiri rebra, najčešće u srednjoj aksilarnoj liniji. Istraživanje je pokazalo kako 24.2 % bolesnika je pri prijemu u bolnicu imalo komplikacije, dok je 75.8 % bilo bez komplikacija. Najčešće komplikacije su hematotoraks, pneumotoraks, subkutani emfizem, te kontuzija pluća. Zabilježen je porast komplikacija 72 sata nakon ozljede u 66. % bolesnika.
Ozlijeđeni bolesnici predstavljaju izazov za zdravstvene djelatnike, cjelokupni zdravstveni sustav i njegove financijske resurse. |
| Abstract (english) | Trauma of the chest cage is a potentially fatal injury considering the placement of vital organs. Early intervention is of crucial importance when increasing the survival rate. Chest cage trauma is the second most fatal category of a traumatic injury. It is of vital importance to know the anatomy of the chest to ensure that size and character of the injury can be assessed correctly.
Chest cage injuries can be either external or internal. Rib fracture is one of the most frequently occurring traumatic injuries in the chest area. Clinical assessment is dependent upon the number of injured ribs, following injuries and complications. Possible complications regarding rib fracture are unstable chest cage, pneumothorax, subcutaneous emphysema, hemothorax, diaphragm rupture, spleen and liver rupture, tracheal injury, bronchial injury, and large blood vessel injury. Treatment is dependent upon the severity of the injury. Some of the conservative measures when treating rib fracture are adequate analgesia, breathing and coughing exercises, and preventing lung tissue infections. When treating severe injuries and complications, surgical treatment is needed.
The theme of this work is to analyze and showcase prevalence complications regarding rib fracture in Klinički bolnički centar Rijeka, at The Department of Cardiothoracic Surgery, from 01. 01. 2018. to 01. 05. 2019. Complication frequencies of rib cage fracture in patients who are regularly taking anticoagulants and antiaggregants were compared to those in patients who are not taking those medications.
The research was conducted on 120 patients, 70.8 % of them were male, and 29.2 % were female. Highest percentage of injuries was noted for fracture of three to four ribs, most frequently in the central axillary line. Research has shown that 24.2% of patients had rib cage fracture related complications upon hospital registration, while 75.8 % had shown none of the complications. The most frequent complications were hemothorax, pneumothorax, subcutaneous emphysema, and lung contusion. It has also been noted that complications appear 72 hours after the injury in 66.0 % of the examined patients.
It is important to conduct such research because patients with complex thorax injuries such as rib fracture present a challenge for healthcare professionals, the entire healthcare system, and its financial resources. Moreover, rapid and precise treatment of rib fracture and related complications reduces time spent in hospital care and ensures faster recovery. |
