隐匿性胸部创伤指X线片检查正常而CT扫描异常的胸部创伤，发生率为37．3％～71％，以肋骨骨折、气胸、血胸及肺挫伤等较为常见。尽管多数隐匿性胸部创伤不需特殊处理，但有的可能导致严重后果，临床上仍应高度重视。上胸部隐匿性肋骨骨折，提示创伤严重，而下胸部肋骨骨折，可能存在腹腔实质脏器损伤。隐匿性气胸需要机械通气时不必预防性安置胸腔引流，但需密切观察，一旦病情进展，需及时处理。隐匿性血胸厚度≥1．5cm，宜安置胸腔引流管，以免发生并发症。尽管隐匿性肺挫伤发生率高，但其治疗方案需结合其他临床指标。%Occult chest trauma is defined as a lesion identified on CT but normal finding on chest radio-graphy.The incidence of occult chest trauma occurs in 37.3%-71%of patients.The relatively common occult chest traumas include rib fracture ,pneumothorax ,hemothorax and pulmonary contusion .Although the most majority of oc-cult chest trauma can be safely observed ,some may lead to sever clinical sequence .Therefore,it is still necessary to attach importance to these diseases .The upper occult rib fracture suggest a severe chest trauma ,and lower occult rib fractures are a risk factor for abdominal solid organ injuries .Tube thoracotomy is not an argument for patients with occult pneumothorax requiring positive pressure ventilation ,however ,close observation is warranted and chest drain-age should be performed immediately as soon as the occult penumothorax progression has been found .The patient with occult hemothorax ≥1.5cm in thickness had better undergo a chest tube insertion to prevent complications . Despite the greater frequency of occult pulmonary contusion ,its management should refer to other clinical examina-tion results.
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