胸部钝性伤致心脏破裂的救治

Surgical treatment of rupture of heart caused by blunt injury of chest

目的探讨胸部钝性伤导致心脏破裂的外科救治方法。方法回顾性总结20例胸部钝性伤致心脏破裂的外科治疗经验。结果本组存活16例,均痊愈出院,随访3个月,心脏功能正常;死亡4例,其中术中死亡2例,术后死亡2例。结论胸部钝性伤引起心脏破裂病例并不少见,抢救成功的关键是争取手术时间。心脏破裂部位以右心为多见,手术进路以胸骨正中切口为佳。应强调术中控制出血的有效措施及可靠的心脏破裂修补方法。

Objective To summarize the experience in the surgical treatment of heart rupture caused by blunt injury of chest. Methods The clinical data of 20 cases of heart rupture caused by blunt injury of chest were retrospectively reviewed. Results Sixteen patients survived and recovered with a follow-up of 3 months. Four cases died, among which 2 eases died during the operation, and the other 2 cases died after the operation. Conclusion The key of the treatment is to operate as early as possible. The best approach-is-by cleavage of the sternum because of more heart rupture occurs in the right heart. The importance of effective bleeding control an.d the right heart rupture repaire should be emphasized.