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目的探讨凝固性血胸（Traumatic clotted hemothorax，TCHT）的诊断、原因及治疗方法，以便提高疗效。方法回顾性分析我院自2005年1月~2012年12月38例凝固性血胸的临床资料。行胸膜腔内尿激酶注射治疗15例，胸腔镜下凝固性血胸清除术和（或）纤维板剥脱术26例。结果保守治疗15例，12例肺复张完全，治愈率达80%，电视胸腔镜（VATS)下病灶清除术，有效率达100%。结论诊断不及时、治疗不得当、胸膜腔引流不通畅等是造成凝固性血胸的常见原因，对于伤侧肺压缩少，症状轻，凝固性血胸早期，可采用胸膜腔内尿激酶注射治疗，方法简单、创伤小，经济有效；对于伤侧肺压缩大于50%，或有血胸感染倾向，有手术指征且无手术禁忌的，应尽早手术，促进肺复张，恢复肺功能。“,”Objective: To investigate the coagulability hemothorax diagnosis causes and methods of treatment,in order to improve the curative ef ect. Methods:A retrospective analysis of our hospital from January 2005-December 2005,the clinical data of 38 cases of coagulability hemothorax.15 cases treated with urokinase injection Line within the pleural cavity,under the thoracoscope coagulability for removal of hemothorax and (or) fiber board stripped 26 cases. Results:15 cases of conservative treatment,and 12 cases of lung after complete,ef icient was 80%,and the removal of lesions under thoracoscope,completely lung after zhang more than 95%.Conclusion:timely diagnosis and treatment shal not when,the pleural space drainage unobstructed is the common cause of traumatic clot ed hemothorax,to side less lung compression injury,symptoms,early blood coagulability chest,can be used within the pleural cavity urokinase injection treatment,the method is simple,smal trauma,economic and ef ective;For lung compression injury side is more than 50% or have a tendency to blood chest infection,surgical indications and no surgery taboo should surgery as soon as possible,promote lung after zhang,lung function recovery.