2023年 · 第39卷第09期

Trauma is an important cause of abnormal death in humans, chest trauma accounts for about 25% of trauma, and rib fracture is the most common chest wall injury (>50%)^[1]。 In the past ten years, both abroad and at home, thanks to the increasing progress of surgical materials and instruments, surgical stabilization of rib fracture (SSRF) has been widely carried out in hospitals of all levels, benefiting a large number of patients. Although there have been some expert consensus or guidelines at home and abroad, due to the lack of systematic clinical research, the evidence of evidence-based medicine is few and low, there are a series of problems such as narrow coverage and vague views, and there are blind spots in many aspects. Sternal fracture accounts for about 3% ~8% of patients admitted for chest trauma^[2]In the past, conservative treatment was the main treatment. For sternal fractures with obvious displacement, conservative treatment often failed, such as nonunion, severe chest pain, dyspnea and contradictory movements of the chest wall, and surgical fixation was more and more widely carried out. At present, thoracic surgery, emergency surgery (trauma) department, orthopedics and general surgeons are performing related operations. Due to the lack of unified and standardized programmatic guidance, there is excessive medical treatment or delayed treatment. The "China Chest Trauma Clinical Research Collaborative Group" jointly sponsored by dozens of hospitals across the country China Chest Injury Research Society (CCIRS) "^[3]A large number of single-center and multi-center clinical studies have been conducted on chest trauma. On this basis, the Thoracic and Cardiovascular Surgery Branch of Chinese Medical Association took the lead to plan and formulate the "Chinese Expert Consensus on Surgical Diagnosis and Treatment of Traumatic Rib and Sternum Fractures". The consensus focuses on surgery rather than general management of chest injuries, so some basic issues such as management of pulmonary contusion, mechanical ventilation, etc. are omitted.

tetralogy of Fallot (TOF) is a complex congenital heart disease consisting of ventricular septal defect, right ventricular outflow tract obstruction, aortic riding and right ventricular hypertrophy. Although the pathophysiological mechanism of TOF has been relatively clear, the treatment plan has been continuously improved after decades of experience accumulation, and the postoperative survival rate of patients is satisfactory, and the survival time is getting longer and longer. At present, adult postoperative patients have become a large number of people; According to the long-term follow-up results, clinicians also put forward some new insights on the treatment modalities of TOF.