28例心脏创伤的外科急诊救治体会

Experience of surgical emergency rescue for cardic traumas in 28 cases

目的总结心脏创伤的急诊救治方法,以提高生存率。方法回顾11年间收治的28例心脏创伤的急诊救治资料。所有患者经心脏彩超确诊。对25例穿透性损伤患者及时行开胸手术修补。结果25例患者接受手术治疗,4例术中死于心跳骤停,2例术后死于室颤,2例死于严重复合伤(脑及肝脏),全组死亡率28.5%。结论及时诊断、及时手术是心脏创伤急诊救治的关键,心脏彩超是明确诊断的可靠手段,开胸手术修补心脏破损是治疗穿透性心脏损伤唯一有效的方法。

Objective To summarize the with cardiac trauma, and improve the survival rate. emergent diagnosis and treatment of the patient Methods The clinical date of 28 cases with cardiac traumas were retrospectively analyzed in the past 11 years. The diagnosis of cardiac traumas were confirmed by cardiac color uhrasonography in all cases. The 25 cases with penetrating injury underwent thoracotomy, including repair of cardiac rupture. Results In 25 cases with cardiac penetrating inujry received operative treatment, 4 cases died from intraoperative cardiac arrest, 2 cases died from severe venticular fibrillation after operation. In 3 cases with cardiac contusion, 1 cases cured and 2 cases died from complex injuries（brain and liver）. Conclusion Prompty dignosis and operation are the keys to treat the patients with cardiac penetrating inujry. Cardiac color uhrosonography is a reliable means to make the correct diagnosis. Thoracotomy and repair cardiac rupture is an effective method for the treatment of cardiac penetrating injure.