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Die Unfallchirurgie

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01.10.2004 | Originalien

Diagnostik und sofortige Therapiemaßnahmen bei Verletzungen des Thorax

Eine systematische Literaturübersicht

verfasst von: PD Dr. G. Voggenreiter, C. Eisold, S. Sauerland, U. Obertacke

Erschienen in: Die Unfallchirurgie | Ausgabe 10/2004

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Zusammenfassung

Fragestellung.

Thoraxverletzungen tragen wesentlich zur Morbidität und Mortalität von Schwerstverletzten bei. Diese Übersicht untersucht die im Rahmen der Schockraumversorgung notwendige klinische Diagnostik und erforderliche Sofortmaßnahmen.

Methodik.

Klinische Studien wurden über systematische Literatursuchen (Medline, Cochrane und Handsuchen) und Klassifikation nach Evidenzgüte (Level 1–5 nach Oxford-Schema) zusammengetragen.

Ergebnisse.

Einige wenige Studien belegen die Bedeutung des Unfallmechanismus und die der körperlichen Untersuchung. So deuten insbesondere Hochrasanztraumen und Verkehrsunfälle mit Lateralaufprall auf ein Thoraxtrauma. Die Auskultation hat einen hohen Stellenwert zum Nachweis eines Pneumothorax. Eine zentrale Rolle in der Diagnostik nimmt das Spiral-CT des Thorax ein, insbesondere bei der Aortenruptur. Ob eine Entlastung CT-diagnostizierter ventraler Pneumothoraces in jedem Falle notwendig ist, ist derzeit noch nicht hinreichend geklärt. Der Stellenwert von Intubation und Beatmung im Schockraum ist nur unzureichend untersucht und beruht großteils auf Expertenmeinungen.

Schlussfolgerungen.

Zur Schockraumdiagnostik und Therapie des Thoraxtraumas liegen eine Vielzahl vergleichender (EL 2) Untersuchungen vor, randomisierte Studien existieren jedoch wenige. Anhand der Datenlage ist eine wissenschaftlich begründete Behandlung dieser Patienten in weiten Bereichen möglich.

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Titel: Diagnostik und sofortige Therapiemaßnahmen bei Verletzungen des Thorax
Eine systematische Literaturübersicht
verfasst von: PD Dr. G. Voggenreiter
C. Eisold
S. Sauerland
U. Obertacke
Publikationsdatum: 01.10.2004
Verlag: Springer-Verlag
Erschienen in: Die Unfallchirurgie / Ausgabe 10/2004
Print ISSN: 2731-7021
Elektronische ISSN: 2731-703X
DOI: https://doi.org/10.1007/s00113-004-0837-4

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Schockraummanagement bei Verletzungen der Wirbelsäule im Rahmen eines Polytraumas

Personelle und strukturelle Voraussetzungen der Schockraumbehandlung Polytraumatisierter

Arthropedia

Neu im Fachgebiet Orthopädie und Unfallchirurgie

Therapiestart mit Blutdrucksenkern erhöht Frakturrisiko

Ärztliche Empathie hilft gegen Rückenschmerzen

Stereotaktische Radiatio schlägt konventionelle Bestrahlung

Vorsicht mit hohen NSAR-Dosen bei ankylosierender Spondylitis!

Update Orthopädie und Unfallchirurgie