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Thoraxtrauma und Thoraxdrainage: Diagnostik und Therapie—Ein systematisches Review

Teil 2: Therapie

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Zusammenfassung

Die Indikation zur Dekompression bzw. Drainage eines Pneumothorax nach Thoraxtrauma wird präklinisch nach dem klinischen Zustand (Spannungspneumothorax), der Notwendigkeit der Beatmung und den Überwachungs- und Therapiemöglichkeiten während des Transports gestellt. Prinzipiell stehen 3 therapeutische Möglichkeiten zur Verfügung: die Nadeldekompression, die Minithorakotomie und die Pleuradrainage. Die Methodenwahl wird sich insbesondere auch nach der Erfahrung des Notarztes richten. Die Nadeldekompression ist einfach und komplikationsarm, jedoch nicht immer effektiv. Dagegen ist die Pleuradrainage als definitive Versorgung anzusehen und mit einer hohen Erfolgsquote versehen. Die einfache chirurgische Eröffnung ist technisch unkompliziert, jedoch liegen keine Daten zu Rezidiv- und Komplikationsraten vor. Technik und Instrumentarium der Therapie des Pneumothorax bei Thoraxtrauma wird nachfolgend dargestellt.

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Authors and Affiliations

  1. Klinik und Poliklinik für Unfallchirurgie, Universitätsklinikum Essen

    C. Waydhas

  2. II. Chirurgischer Lehrstuhl, Universität zu Köln

    S. Sauerland

  3. Klinik und Poliklinik für Unfallchirurgie, Universitätsklinikum Essen, Hufelandstraße 55, 45147, Essen

    C. Waydhas

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  1. C. Waydhas
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Waydhas, C., Sauerland, S. & : . Thoraxtrauma und Thoraxdrainage: Diagnostik und Therapie—Ein systematisches Review. Notfall & Rettungsmedizin 6, 627–639 (2003). https://doi.org/10.1007/s10049-003-0614-x

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