贯穿性心脏损伤的诊断和治疗

DIAGNOSIS AND TREATMENT OF PENETRATING CARDIAC TRAUMA

目的：本文报告65例贯穿性心脏损伤的救治体会，旨在提高贯穿性心脏损伤的早期诊断和手术治疗水平。方法：本组病例根据外伤史、临床征象进行早期诊断，部分病例结合床旁胸部X线和超声心动图或心包穿刺术确立诊断。全组均经手术治疗，19例危重者紧急送入手术室剖胸手术，2例因入病房时心脏停搏在监护室行剖胸术，本组余者分别于0．5～5h内剖胸手术。结果：本组61例获救痊愈，治愈率为93．8％；4例死亡，死亡率为6．2％。结论：贯穿性心脏损伤救治成败的关键在于尽早明确诊断、果断迅速处理、以及选择适当的手术方法和途径。

Aim: The experience of the diagnosis and treatment for 65 cases of penetrating cardiac trauma is reported in the article in order to improve the level of early diagnosis and operative treatment. Methods: The early diagnosis was obtained according to the history of trauma, clinical signs that combined with the chest X-ray,echocadiogram and pericardiocentesis in some of the patients. All patients underwent operation. Out of them 19 cases Severe with injury were operated immediatly in the operating room. While 2 cases with sudden arrest of heart beat were operated in ICU. The others were operated from 0. 5 hour to 5 hour after admission. Result: 61 cases were cured accounting for 93. 8% of the curative ratio. 4 cases died accounting for 6. 2% of the operating mortality.Conclusion: Early diagnosis, prompt treatment and reasonable choice of operative procedure are important factors that influences the final results.