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Management and outcome of bronchial trauma due to blunt versus penetrating injuries

World Journal of Clinical Cases 2022年第16期10卷 5185-5195页

作者： Jin-Mou Gao Hui Li Ding-Yuan Du Jun Yang Ling-Wen Kong Jian-Bai Wang Ping He Gong-Bin Wei Department of Traumatology Chongqing University Central HospitalChongqing Emergency Medical CenterChongqing 400014China Department of Cardiothoracic Surgery Chongqing University Central HospitalChongqing Emergency Medical CenterChongqing 400014China

BACKGROUND The number of patients with bronchial trauma(BT)who survived to hospital admission has increased with the improvement of prehospital care;early diagnosis and treatment should be considered,especially among blunt trauma patients,whose diagnosis is frequently *** To describe the early recognition and surgical management considerations of blunt and penetrating BTs,and to elaborate the differences between *** All patients with BTs during the past 15 years were reviewed,and data were retrospectively analyzed regarding the mechanism of injury,diagnostic and therapeutic procedures,and *** to the injury mechanisms,the patients were divided into two groups:blunt BT(BBT)group and penetrating BT(PBT)*** injury severity,treatment procedures,and prognoses of the two groups were *** A total of 73 patients with BT were admitted during the study *** proportion of BTs among the entire cohort with chest trauma was 2.4%(73/3018),and all 73 underwent *** patients accounted for 81.6% in the BBT group and 22.9%in the PBT group,and the mean Injury Severity Score was 38.22±8.13 and 21.33±6.12,*** three-dimensional spiral computed tomography(CT)and/or fiberoptic bronchoscopy(FB)were performed in 92.1% of cases in the BBT group(n=38)and 34.3% in the PBT group(n=35).In the BBT group,a delay in diagnosis for over 48 h occurred in 55.3% of *** the PBT group,31 patients underwent emergency thoracotomy due to massive hemothorax,and BT was confirmed during the *** them,22 underwent pulmo-tractotomy for hemostasis,avoiding partial *** this series,the overall mortality rate was 6.9%(5/73),and it was 7.9%(3/38)and 5.7%(2/35)in the BBT group and PBT group,respectively(P>0.05).All 68 survivors were followed for 6 to 42(23±6.4)mo,and CT,FB,and pulmonary function examinations were performed as *** patients exhibited normal lung function and healthy conditi

关键词： Bronchial trauma Bronchial repair blunt Penetrating Atelectasis Pneumonectomy

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Stress distribution and effective stress intensity factor of a blunt crack after dislocation emission

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Science China(Technological Sciences) 2000年第4期43卷 421-429页

作者：钱才富乔利杰褚武扬 Department of Mechanical Engineering Beijing University of Chemical Technology Beijing 100029 China Department of Material Physics Beijing University Of Science & Technology Beijing 100083 China

The stress fields induced by a dislocation and its image dislocations around a narrow elliptic void are formulated. Based on the solution, the stress distribution and effective stress intensity factor of a blunt (elliptic) crack were calculated under mode I constant loading. The results show that a dislocation-free zone (DFZ) is formed after dislocation emission. There exists a second stress peak in the DFZ except a stress peak at the blunt crack tip. With an increase in the applied stress intensity factor Kla or the friction stress T, of the material, the DFZ size and the peak stress at the crack tip decrease, but the peak stress in the DFZ and the effective stress intensity factor Klf presiding at the crack tip increase. Because of dislocation shielding effects, shielding ratio Kla/Klf increases with increasing Kla, but it decreases with increasing Tf.

关键词： blunt crack dislocation emission stress distribution effective stress intensity factor.

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Simulation of aerodynamic performance affected by vortex generators on blunt trailing-edge airfoils

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Science China(Technological Sciences) 2010年第1期53卷 1-7页

作者： YANG Ke1,2,ZHANG Lei1,3 & XU JianZhong1,2 1 Institute of Engineering Thermophysics,Chinese Academy of Sciences,Beijing 100190,China 2 Key Laboratory of Wind Energy Utilization,Chinese Academy of Sciences,Beijing 100190,China 3 Graduate School of Chinese Academy of Sciences,Beijing 100190,China Institute of Engineering Thermophysics Chinese Academy of Sciences Beijing China Key Laboratory of Wind Energy Utilization Chinese Academy of Sciences Beijing China Graduate School of Chinese Academy of Sciences Beijing China

An investigation was carried out by numerical simulation on a wind turbine airfoil and a blunt trailing-edge airfoil with and without vortex generators (VGs), and the performance of the airfoils was analyzed. By the simulation of airfoil DU 91-W2-250 it was verified that the numerical method and model were credible. Based on this airfoil, a new one with a blunt trailing edge of 6% chord was blended by symmetrically adding thickness, and its characteristics curves were obtained through computing at key angles of attack. Additionally, the pressure distribution on blended airfoil was analyzed by comparing to the airfoil without blend. The interaction of streamwise vortices induced by VGs with trailing vortex or separation vortex was considered, followed by the uncovery of how VGs can suppress the boundary layer separation.

关键词： vortex generators airfoil blunt trailing-edge

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Receptivity to free-stream disturbance waves for hypersonic flow over a blunt cone

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Science China(Physics,Mechanics & Astronomy) 2008年第11期51卷 1682-1690页

作者： ZHANG YuDong FU DeXun MA YanWen LI XinLiang China Academy of Aerospace Aerodynamics Beijing 100074China LNM Institute of MechanicsChinese Academy of SciencesBeijing 100190China

A high-order shock-fitting finite difference scheme is studied and used to do direc-tion numerical simulation (DNS) of hypersonic unsteady flow over a blunt cone with fast acoustic waves in the free stream, and the receptivity problem in the blunt cone hypersonic boundary layers is studied. The results show that the acoustic waves are the strongest disturbance in the blunt cone hypersonic boundary layers. The wave modes of disturbance in the blunt cone boundary layers are first, second, and third modes which are generated and propagated downstream along the wall. The results also show that as the frequency decreases, the amplitudes of wave modes of disturbance increase, but there is a critical value. When frequency is over the critial value, the amplitudes decrease. Because of the discontinuity of curvature along the blunt cone body, the maximum amplitudes as a function of frequencies are not monotone.

关键词： receptivity shock-fitting compact upwind scheme DNS blunt cone

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Common iliac artery occlusion with small intestinal transection caused by blunt abdominal trauma: A case report and review of the literature

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World Journal of Clinical Cases 2019年第15期7卷 2120-2127页

作者： You-Xin Zhou Yong Ji Jing Chen Xin Yang Qing Zhou Jian Lv Department of General Surgery People’s Hospital of JingjiangYangzhou University Medical AcademyJingjiang 214500Jiangsu ProvinceChina Imaging Department People’s Hospital of JingjiangYangzhou University Medical AcademyJingjiang 214500Jiangsu ProvinceChina Department of General Surgery Affiliated Hospital of Jiangsu UniversityZhenjiang 212000Jiangsu ProvinceChina

BACKGROUND Most major abdominal vascular injuries are caused by penetrating injuries.A common iliac artery occlusion caused by blunt force trauma is rare,and very few cases have been *** of this low incidence,atypical symptoms,and frequent association with other severe injuries,the proper diagnosis tends to be missed or *** gold standard for diagnosis is angiography,and treatment remains a *** SUMMARY We report here the unusual case of a common iliac artery occlusion caused by blunt abdominal compressive trauma,with transection of the small *** presentation,the patient(a 56-year-old man)complained of pain and numbness in the left lower extremity and severe pain in the whole *** examination showed total abdominal tenderness with evidence of peritoneal *** left lower limb was pulseless and *** computed tomography examination revealed digestive tract perforation,and abdominal computed tomography angiography showed left common iliac artery *** patient was treated successfully by anastomosis of the intestine,percutaneous transluminal angioplasty,and *** patient was followed for more than 11 mo after the operation and showed a good *** Patients with abdominal trauma should be suspected of having major vascular *** treatment strategies are needed for this condition.

关键词： Common iliac artery occlusion Transection of the small intestine blunt abdominal trauma Case report Percutaneous transluminal angioplasty Anastomosis of the intestine

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Management of bronchial rupture after blunt chest trauma in children

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Chinese Medical Journal 2019年第8期132卷 987-989页

作者： Yu-Hao Wu Shou-Liang Jiang Yue-Hang Zhou Xin Ji Yong-Gang Li Chun Wu Department of Cardiothoracic Surgery Children's Hospital of Chongqing Medical UniversityMinistry of Education Key Laboratory of Child Development and DisordersInternational Science and Technology Cooperation Base of Child Development and Critical DisordersChongqing Key Laboratory of PediatricsChongqing 400014China West China Woman's and Children's Hospital ChengduSichuan 610000China

To the Editor:Bronchial rupture due to blunt chest injury in children is very rare and can go undiagnosed for over 48 *** surgical repair following definitive diagnosis by three-dimensional computed tomography(3D-CT)and bronchoscopy,complications from anastomotic stricture can arise,particularly in very young *** study aimed to present an algorithm for improved early diagnosis and report learnings from treatment of bronchial rupture after blunt chest trauma in nine children.

关键词： bronchial rupture after blunt chest trauma children three-dimensional computed tomography(3D-CT)

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Ascending aorta disruption after thoracic blunt trauma

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Chinese Journal of Traumatology 2020年第1期23卷 32-33页

作者： Francesco Giosue Irace Valentina Rico Domenico Ciuffetta Fabio Miraldi “Paride Stefanini”Department Policlinico“Umberto I” Sapienza UniversityRomeItaly Cardiac Department Sapienza UniversityRomeItaly SS Trinita Hospital SoraItaly

blunt traumatic aortic injury is the second leading cause of death after motor vehicle *** most frequent localisation of aortic lesion is the isthmus,especially in those who survived the *** we report a case of blunt traumatic aortic injury with unusual localisation and modality.A 31 years old man sustained a motorcycle accident,being run over by a *** tomography scan showed an atypical ascending aorta lesion,confirmed by intraoperative *** patient underwent emergency ascending aorta replacement with Dacron tubular *** patient was discharged uneventfully on 35th postoperative day,after multiple maxillofacial surgeries for concomitant injuries.

关键词： Ascending aorta blunt injury Aortic dissection

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Isolated free intra-abdominal fluid on CT in blunt trauma： The continued diagnostic dilemma

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Chinese Journal of Traumatology 2015年第6期18卷 357-359页

作者： Victor Y. Kong Damon Jeetoo Leah C. Naidoo George V. Oosthuizen Damian L. Clarke Pietermaritzburg Metropolitan Trauma Service Department of Surgery Nelson R Mandela School of Medicine University of KwaZulu Natal Durban South Africa

Purpose： The clinical significance of isolated flee fluid （FF） without solid organ injury on computed to- mography （CT） continues to pose significant dilemma in the management of patients with blunt abdominal trauma （BAT）. Methods： We reviewed the incidence of FF and the clinical outcome amongst patients with blunt abdominal trauma in a metropolitan trauma service in South Africa. We performed a retrospective study of 121 consecutive CT scans over a period of 12 months to determine the incidence of isolated FF and the clinical outcome of patients managed in a large metropolitan trauma service, Results： Of the 121 CTs, FF was identified in 36 patients （30%）. Seven patients （6%） had isolated FF. Of the 29 patients who had free fluid and associated organ injuries, 33 organ injuries were identified. 86% （25/ 29） of all 29 patients had a single organ injury and 14% had multiple organ injuries. There were 26 solid organ injuries and 7 hollow organ injuries. The 33 organs injured were： spleen, 12; liver, 8; kidney, 5; pancreas, 2; small bowel, 4; duodenum, 1. Six （21%） patients required operative management for small bowel perforations in 4 cases and pancreatic tail injury in 2 cases. All 7 patients with isolated FF were initially observed, and 3 （43%） were eventually subjected to operative intervention. They were found to have an intra-peritoneal bladder rupture in 1 case, a non-expanding zone 3 haematoma in I case, and a negative laparotomy in 1 case. Four （5？%） patients were successfully managed without surgical interventions. Conclusions： Isolated FF is uncommon and the clinical significance remains unclear. Provided that reli- able serial physical examination can be performed by experienced surgeons, an initial non-operative approach should be considered.

关键词： blunt Trauma Computed Tomography Non Operative Management Abdominal Injury

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Emergency percutaneous thoracic endovascular aortic repair for patients with traumatic thoracic aortic blunt injury: A single center experience

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Chinese Journal of Traumatology 2020年第1期23卷 15-19页

作者： Xin Pu Xiao-Yong Huang Lian-Jun Huang Department of Intervention Diagnosis and Therapy Beijing Anzhen HospitalCapital Medical UniversityBeijing 100029China

Purpose:To analyze the efficacy and outcome of percutaneous thoracic endovascular aortic repair(TEVAR)in patients with traumatic blunt aortic injury in our ***:From January 2014 to December 2018,a total of 89 patients with traumatic blunt aortic injuries were treated with emergency TEVAR in our *** clinical data such as demographics,operative details and postprocedure outcomes were analyzed retrospectively in this study using SPSS 20 *** variables were expressed as mean and standard deviation or median and interquartile *** variables are expressed as the numbers and percentages of ***:The median age of the patients was 37 years,and 76(85.4%)were *** the patients were involved in violent accidents and combined with associated *** patients died while awaiting the operations and 87 patients underwent emergency percutaneous TEVAR,with a 100%technique *** mean time interval from admission to operating room was(90.1±18.7)min,and the mean procedure time was(54.6±11.9)***(92.0%)patients were operated on under local anesthesia,while other 7(8.0%)patients were under general *** cases underwent open repair of the femoral arteries because of the pseudoaneurysm formation of the access vessels.A total of 98 aortic covered stent grafts were deployed,of which 11 patients used two stent grafts(all in dissection cases).The length of the stent was(177.5±24.6)*** horizontal diameter of aorta arch at the proximal left subclavian artery ostium was(24.9±2.4)mm,the proximal diameter of the covered stent was(30.5±2.6)mm,and the oversize rate of proximal site was(22.7±4.0)%.The proximal landing zone length was(14.1±5.5)*** left subclavian artery ostium was completely covered in 5 patients and partially covered in 32 *** blood flow reconstruction was *** overall aortic-related mortality was 2.25%(2/89).Among 87 patients,the median follow-up time was 24 months.

关键词： Nonpenetrating wounds blunt aortic injury Endovascular aortic repair

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Thoracic endovascular aortic repair with left subclavian artery reconstruction for blunt traumatic aortic injury in elderly patients

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Journal of Interventional Medicine 2019年第4期2卷 150-153页

作者： Li Zhang Huaping Wu Xiang Li Kaiping Lv Huanhuan Song Cunliang Zeng Jianlin Liu Department of Vascular Surgery Dazhou Central HospitalDazhou635000PR China Department of Vascular Surgery The First Affiliated Hospital of Xi’an Jiaotong UniversityXi’an710000PR China

Introduction:blunt thoracic aortic injury(BTAI)is rare in elderly *** the population ages and life expectancy increases,the frequency of this injury will increase,while the treatment and outcomes remain ***:We retrospectively analyzed the collected data of patients>60 years old with BTAI to investigate the mechanism of trauma;time interval from injury to diagnosis;type and timing of surgical intervention;aortic arch pattern;choice of left subclavian artery reconstruction;endograft to treat BTAI;length of the endovascular procedure;endoleaks;complications including stroke,paraplegia,and renal failure;length of hospital stay(LOS)and intensive care unit stay(***);and 30-day ***:Five elderly trauma patients were found to have ***(80%)were males,the cohort mean age was68 years,the major mechanism of trauma was fall injury,and the associated injury was thoracic *** patients were transferred to our hospital,and emergency computed tomography angiography showed BTAI in each *** average time interval from injury to diagnosis was 2.7 *** patients suddenly showed signs of instability in their vital signs and underwent immediate endovascular repair,while 3 patients underwent delayed endovascular *** injury site was located in the aortic isthmus just distal to the origin of the left subclavian artery;the aortic arch pattern was II(80.0%)in 4 cases and III in 1 case(20.0%).The choice of left subclavian artery reconstruction included chimney,double chimney,prefenestration,and chimney combined with in situ *** to treat BTAI included the Ankura(Lifetech Scientific,Shenzhen,China)and the C-TAG(***&Associates,Flagstaff,AZ USA).The length of the endovascular procedure was 75.4 min;there were no endoleaks and no complications including stroke,paraplegia,or renal *** average LOS was25 days,and the average *** of 2 patients was 15 days,with no 30-day ***:Elderly patien

关键词： blunt traumatic aortic injury Thoracic endovascular repair Reconstruction of left subclavian artery

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