胸部外伤致心脏损伤78例诊治体会

Diagnosis and treatment of cardiac injury following traumatic chest injury

目的总结胸部外伤致心脏损伤的诊断与治疗经验。方法分析203例以胸伤为主引发心脏损伤的78例患者的临床资料。结果78例心脏损伤患者中,痊愈出院74例,死亡4例,2例死于紧急术前准备时,2例死于术中;入院时诊断正确18例,占23.08%;60例(76.92%)因胸部外伤处理后患者症状缓解不理想再考虑到心脏损伤而被证实。结论胸伤引发的心脏损伤并不少见,除外易诊断病例,排除心脏病史,心电图检查、血清心肌酶谱或CT nⅠ测定对诊断心脏损伤简便可行,能达到早期诊断、及时治疗的目的。

objective To elucidate the diagnosis and treatment of cardiac injury elicited by traumatic chest injury. Methods From 2004 to April 2006, 78 cases of cardiac injure had been collected from 203 cases of traumatic chest injuries and the data were retrospectively analysed. Results Among the 78 cases, 74 cases recovered, 4 cases died in whom 2 cases died before emergent operation and 2 cases died during operation. Correct diagnosis was made on admission in 18 cases and for other 60 cases, the diagnoses were confirmed when the symptoms and signs were mot alleviated after treatment to the chest injury（76.9%）. Conclusion Cardiac injury is often caused by traumatic chest injury. Regarding its diagnosis, first we should exclude the history of cardiac disease, and then use the examinations of electric cardiography, CTn I or cardiac enzymology combined with clinic symptoms and signs to make a correct diagnosis at early time.