外伤性心肌梗死临床分析

Clinical analysis of traumatic myocardial infarction

目的:分析外伤性心肌梗死的发病情况和临床表现、诊断、治疗、预后及其他有关问题。方法:对21例外伤病人伤后心肌梗死的发病情况、外伤类型、以及心梗的临床表现、心梗的类型、诊断及转归进行了分析,并对其发病机制和其他相关问题进行了讨论。结果:21例病人外伤后至心梗的发病时间最短者0.5小时,最长者24小时,多数在伤后1～2小时发病,由于外伤症状的掩盖,有的病人症状常不典型,但常规的心电图及酶学等检查均能明确诊断。经积极的治疗,1例由于病人高龄、1例入院时情况危重而死亡外,其余病人均康复出院,预后良好。结论:外伤性心肌梗死在外伤的病人中较常见,接诊医生提高警惕能及时给予明确的诊断,预后良好。不同类型的外伤与心肌梗死的关系、以及不同部位心梗与外伤的关系,由于病例较少,未能进行分析。其发病机制不是单一原因,而是多因素而致。

Objective： To analysisthe pathogenesis, clinical manifestation, diagnosis, treatment, prognosis and other related aspects of traumatic myocardial infarction. Methods： Analysis of 21 cases of myocardial infarction after trauma on their pathogenesis, type of trauma, clinical manifestation, classification, diagnosis and prognosis of cardial infarction. Discussion of its pathogenesis and other related questions. Results： Most of the 21 patients got onset of myocardial infarction 1 ~ 2 hours after trauma. The shortest interval between trauma and onset of myocardial infarction was half an hour while the longest was 24 hours. Some of the patients showed atypical symptoms because of interference of trauma symptoms, but routine ECG and enzyme assay can give definite diagnosis. After active treatment, most of the patients got rehabilitation discharge and eusemia except two patients died of senility and serious illness respectively. Conclusions： Traumatic myocardial infarction is common among trauma patients. If doctors pay enough attention and give definite diagnosis in time, the patient can get fine prognosis. As the number of the cases was not enough, we did not analyze the relationship between different type of trauma and myocardial infarction and the relationship between different part of myocardial infarction and trauma. But we can tell that the disease is caused by multiple factors other than single factor.