火器伤后胸心异物存留

Thoracic and Cardiac Foreign Bodies after Fire arm Injury

目的：探讨火器伤后胸心异物存留摘除的指征、时机、方法及结果。方法：回顾性分析了３９例火器伤后胸心异物存留摘除者的一般资料、临床表现、不同处理方法的选择及效果。结果：１９例患者早期因凝固性血胸及肺持续漏气伴异物存留或异物存留伴胸腔及心包腔化脓性感染，在开胸清创时做了异物摘除；另２０例患者为胸伤伤情恢复后单纯异物存留，因异物位于肺门、心脏及大血管旁或远期并发症等，而后期开胸异物摘除。结论：火器性胸部穿透伤后，因异物本身或其他原因所致早期并发症者，应在开胸清创的同时摘除异物；胸伤伤情恢复而单纯胸心异物存留，应选择性摘除或因并发远期并发症而摘除。

Aim: To explore the indications, time of surgical interventions, methods and outcomes of removal of thoracic and cardiac foreign bodies with thoracotomy. Methods and Results: Thirty nine cases of thoracic and cardiac foreign bodies were treated and reviewed in this report. Early removal of foreign bodies was performed in 19 patients with coagulated hemothorax, continuous pulmonary leakage or infection, etc. Late removal of foreign bodies was performed in 20 patients after primary recovery or foreign bodies near great vessels and heart. Conclusion: A thoracotomy and removel of foreign bodies should be conducted in patients endured early complications following penetrating fire arm wound. If thoracic and cardiac foreign bodies are not accompanied by any early complications, the removal should be undertaken cautiously or on the condition that late complications occurred.