心脏穿通伤的临床特点及治疗

Clinical features and management of penetrating cardiac injuries

目的 :总结心脏穿通伤的诊治经验。方法 :1 2例心脏穿通伤 ,年龄 1 7～ 36岁 ,均合并其它部位损伤。 3例术前行心脏超声检查 ;1 2例均手术治疗。结果 :右心室修补 9例 ,双室修补 2例 ,下腔静脉修补 1例。术中死亡 2例 ,术后死亡 1例。心脏穿通伤的主要特点 :( 1 )休克与出血量不成正比 ;( 2 )右室穿通伤多见 ;( 3)临床表现严重且复杂 ,易被其它损伤掩盖。结论

Objective: To evaluate the clinical features and management of penetrating cardiac injuries. Methods: Twelve cases (17-36 years old ) of penetrating cardiac injuries were reviewed. All of them were combined with multiple injuries. Cardiac ultrasonography was performed in 3 cases, and immediate operation in all cases. Results: Nine cases underwent right ventricular repair, 2 cases both ventricular repair and 1 case inferior vena cava repair. The clinical charicteristics of penetrating cardiac injuries were: (1) shock is out of proportion to the bleeding volume; (2) right ventricular injuries are commonly seen; (3) the clinical symptom is usually severe and complicated, and misdiagnosis is quite common. Conclusions: Early diagnosis and prompt surgical intervention are essential for the cure of penetrating cardiac injuries.