بررسي ويژگي هاي اپيدميولوژيك تروماهاي نافذ و غيرنافذ قفسه سينه در سالهاي 1387 و 1388 در بيماران بستري در بيمارستان بعثت همدان

Epidemiological Study of Penetrating and Non-penetrating Thoracic Trauma in Besat Hospital during 2008-2009

ﺯﻣﻴﻨﻪ ﻭ ﻫﺪﻑ: ﺗﺮﻭﻣﺎ ﺷﺎﻳﻌﺘﺮﻳﻦ ﻋﻠﺖ ﻓﻮﺕ ﺩﺭ ﺳﻪ ﺩﻫﻪ ﺍﻭﻝ ﺯﻧﺪﮔﻲ ﺑﻪ ﺷﻤﺎﺭ ﻣﻲﺭﻭﺩ. ﺗﺮﻭﻣﺎﻱ ﻗﻔﺴﻪ ﺳﻴﻨﻪ، 10 ﺗﺎ 30 ﺍﻧﻮﺍﻉ ﺗﺮﻭﻣﺎﻫﺎ ﺭﺍ ﺑﻪ ﺧﻮﺩ ﺍﺧﺘﺼﺎﺹ ﺩﺍﺩﻩ ﻭ ﻣﺴﺌﻮﻝ ﺑﻴﺶ ﺍﺯ 25 ﻣﻮﺍﺭﺩ ﻣﺮﮒ ﻭ ﻣﻴﺮ ﺩﺭ ﺑﻴﻤﺎﺭﺍﻥ ﺗﺮﻭﻣﺎﻳﻲ ﻣﻲﺑﺎﺷﺪ. ﻣﻄﺎﻟﻌﻪ ﺣﺎﺿﺮ ﺑﺎ ﻫﺪﻑ ﺗﻌﻴﻴﻦ ﻭﻳﮋﮔﻲ ﻫﺎﻱ ﺍﭘﻴﺪﻣﻴﻮﻟﻮﮊﻳﻚ ﺗﺮﻭﻣﺎﻫﺎﻱ ﻗﻔﺴﻪ ﺳﻴﻨﻪ ﺩﺭ ﺳﺎﻝﻫﺎﻱ 1387 ﻭ 1388 ﺩﺭ ﺑﻴﻤﺎﺭﺍﻥ ﺑﺴﺘﺮﻱ ﺩﺭ ﺑﻴﻤﺎﺭﺳﺘﺎﻥ ﺑﻌﺜﺖ ﻫﻤﺪﺍﻥ ﺍﻧﺠﺎﻡ ﺷﺪ. ﻣﻮﺍﺩ ﻭ ﺭﻭﺵ ﻫﺎ: ﺩﺭ ﺍﻳﻦ ﻣﻄﺎﻟﻌﻪ ﺗﻮﺻﻴﻔﻲ ﻭ ﮔﺬﺷﺘﻪﻧﮕﺮ ﭘﺮﻭﻧﺪﻩ ﺗﻤﺎﻡ ﺑﻴﻤﺎﺭﺍﻥ ﻣﺒﺘﻼ ﺑﻪ ﺗﺮﻭﻣﺎﻱ ﻗﻔﺴﻪ ﺳﻴﻨﻪ ﮐﻪ ﺑﻪ ﺑﻴﻤﺎﺭﺳﺘﺎﻥ ﺑﻌﺜﺖ ﻫﻤﺪﺍﻥ ﻃﻲ ﺳﺎﻝﻫﺎﻱ 1387ﻭ 1388 ﻣﺮﺍﺟﻌﻪ ﮐﺮﺩﻩ ﺑﻮﺩﻧﺪ، ﻣﻮﺭﺩ ﺑﺮﺭﺳﻲ ﻗﺮﺍﺭ ﮔﺮﻓﺖ. ﺭﻭﺵ ﮔﺮﺩﺁﻭﺭﻱ ﺍﻃﻼﻋﺎﺕ ﺑﺮ ﺍﺳﺎﺱ ﺍﺳﺘﺨﺮﺍﺝ ﺁﻧﻬﺎ ﺍﺯ ﭘﺮﻭﻧﺪﻩ ﻭ ﺛﺒﺖ ﺩﺍﺩﻩﻫﺎ ﺩﺭ ﻓﺮﻡ ﺟﻤﻊﺁﻭﺭﻱ ﺩﺍﺩﻩﻫﺎ ﺑﻮﺩ. ﻳﺎﻓﺘﻪ ﻫﺎ: ﺩﺭ ﻣﻄﺎﻟﻌﻪ ﺣﺎﺿﺮ ﺩﺭ ﻣﺠﻤﻮﻉ ﭘﺮﻭﻧﺪﻩ 568 ﺑﻴﻤﺎﺭ ﻣﻮﺭﺩ ﺑﺮﺭﺳﻲ ﻗﺮﺍﺭ ﮔﺮﻓﺖ. ﻣﻴﺎﻧﮕﻴﻦ ﺳﻨﻲ ﺍﻳﻦ ﺑﻴﻤﺎﺭﺍﻥ 36/70±17/58، ﺑﺎ ﮐﻤﺘﺮﻳﻦ ﺳﻦ 5 ﺳﺎﻝ ﻭ ﺑﻴﺸﺘﺮﻳﻦ ﺳﻦ 98 ﺳﺎﻝ ﺑﻮﺩ. ﺑﻴﺸﺘﺮ ﺍﻳﻦ ﺑﻴﻤﺎﺭﺍﻥ ﻣﺮﺩ87/3 ﺑﻮﺩﻧﺪ. ﺍﮐﺜﺮﻳﺖ ﺟﻤﻌﻴﺖ ﻣﻮﺭﺩ ﻣﻄﺎﻟﻌﻪ )76/8 ﺳﺎﮐﻦ ﺷﻬﺮ ﺑﻮﺩﻧﺪ. 68/5 ﺑﻴﻤﺎﺭﺍﻥ ﻣﺘﺄﻫﻞ ﺑﻮﺩﻧﺪ، 40/7 ﺑﻴﻤﺎﺭﺍﻥ ﺳﻴﮕﺎﺭﯼ ﻭ 8/8 ﻣﻮﺍﺩ ﻣﺨﺪﺭ ﻣﺼﺮﻑ ﻣﻲﮐﺮﺩﻧﺪ. ﺗﻨﻬﺎ ﻳﮏ ﺑﻴﻤﺎﺭ 0/2 ﺍﻟﮑﻞ ﻣﺼﺮﻑ ﻣﻲﮐﺮﺩ. ﻧﻮﻉ ﺗﺮﻭﻣﺎ ﺩﺭ 59/5 ﻣﻮﺍﺭﺩ ﻏﻴﺮ ﻧﺎﻓﺬ ﺑﻮﺩ. ﺩﺭ ﺑﻴﺸﺘﺮ ﻣﻮﺍﺭﺩ ﻋﻠﺖ ﺁﺳﻴﺐ ﺗﺼﺎﺩﻑ ﺑﺎ ﻭﺳﻴﻠﻪ ﻧﻘﻠﻴﻪ ﻣﻮﺗﻮﺭﻱ ﺑﻮﺩ ﺑﻴﻤﺎﺭﺍﻥ ﻓﻮﺕ ﮐﺮﺩﻩ ﺑﻮﺩﻧﺪ. ﻣﻴﺎﻧﮕﻴﻦ ﺳﻨﻲ ﺑﻴﻤﺎﺭﺍﻥ ﻓﻮﺕ ﺷﺪﻩ )22/66 ±61/53 ﺳﺎﻝ( ﺑﻪ ﻃﻮﺭ ﻣﻌﻨﻲﺩﺍﺭﻱ ﺑﺎﻻﺗﺮ ﺍﺯ ﺳﺎﻳﺮ ﺑﻴﻤﺎﺭﺍﻥ )35/30±16/10 ﺳﺎﻝ( ﺑﻮﺩ )0/000= P(. ﻋﻠﺖ ﻣﺮﮒ ﺩﺭ 50 ﻣﻮﺍﺭﺩ ﺷﻮﮎ ﻫﻴﭙﻮﻭﻟﻤﻴﮏ ﺑﻪ ﻫﻤﺮﺍﻩ ﻧﺎﺭﺳﺎﻳﻲ ﺗﻨﻔﺴﻲ ﺑﻮﺩ. ﻧﺘﻴﺠﻪ ﮔﻴـﺮﻱ: ﻧﺘﺎﻳﺞ ﻣﻄﺎﻟﻌﻪ ﺣﺎﺿﺮ ﻧﺸﺎﻥ ﺩﺍﺩ ﺗﺼﺎﺩﻑ ﺑﺎ ﻭﺳﻴﻠﻪ ﻧﻘﻠﻴﻪ ﻣﻮﺗﻮﺭﻱ ﺷﺎﻳﻌﺘﺮﻳﻦ ﻋﻠﺖ ﺁﺳﻴﺐ ﺩﺭ ﺑﻴﻤﺎﺭﺍﻥ ﻣﻮﺭﺩ ﻣﻄﺎﻟﻌﻪ ﺑﻮﺩ. ﺷﺎﻳﻌﺘﺮﻳﻦ ﻋﻠﺖ ﻓﻮﺕ ﺷﻮﮎ ﻫﻴﭙﻮﻭﻟﻤﻴﮏ ﺑﻪ ﻫﻤﺮﺍﻩ ﻧﺎﺭﺳﺎﻳﻲ ﺗﻨﻔﺴﻲ ﺑﻮﺩ ﻭ ﺑﻴﺸﺘﺮ ﺩﺭ ﺳﻨﻴﻦ ﺑﺎﻻ ﺍﺗﻔﺎﻕ ﺍﻓﺘﺎﺩﻩ ﺍﺳﺖ.

Introduction & Objective: Trauma is the most common cause of death during the first three decades of life. Chest trauma apply for 10 to 30% of all traumas and is responsible for 25% of death in trauma patients. Present study was done with the aim of assessing epidemiologic features of chest traumas in admitted to Hamedan Beasat hospital, during 2008-2009. Materials & Methods: In this descriptive retrospective study all patients with chest trauma who had referred to this hospital during years 2008 and 2009 were assessed. Data collection was done by obtaining information from dossiers and registering them in data collection forms. Results: In the present study 568 patients were assessed. The mean age of these patients was 36.70±17.58 years, the minimum age was 5 years and the maximum age was 98 years. Most of these patients were male (87.3%), and the majority of them (76.8%) were living in cities; 68.5% of the patients were married, and 40.7% of patients were smoking cigarette and 8.8% of them were using narcotics. Only one patient (0.2%) was using alcohol. In 59.5% of the cases, the type of trauma was non-penetrating. In most cases cause of injury was motor vehicle accident (43.8%). 5.6% of patients died. The mean age of the dead patients (61.53 ± 22.66 years) was significantly higher than other patients (35.30 ± 16.10 years) (P = 0.000). The cause of death was hypovolemic shock, with respiratory failure in 50% of the cases. Conclusions: The results of the present study showed that motor vehicle accident was the most common cause of injury in the studied patients. The most common cause of death was hypovolemic shock, with respiratory failure and it was mostly seen in older patients