穿透性心脏损伤的特点及急救方法

Clinical features and emergency management of penetrating cardiac trauma

目的总结穿透性心脏损伤的临床特点及急救方法。方法19例穿透性心脏损伤患者，均急诊行开胸探查术，修补心脏裂伤，同时处理合并伤。大量血胸患者术中回输自体血2000-4000ml。结果19例患者中16例痊愈，3例死亡，术中死亡2例，术后1例。结论及时正确诊断、迅速手术、控制出血是抢救穿透性心脏损伤成功的关键。大量血胸患者回输自体血对抢救成功有重要意义。

Objective To summarize the clinical features and emergency management of penetrating cardiac trauma. Methods A total of 19 patients with penetrating cardiac trauma were retrospectively analyzed, including 15 males and 4 females. There were 18 stab wounds and 1 gunshot wound. Patients＇ age ranged from 17 to 36 years old, with the mean age of（24 ±3.5） years. Emergency thoracotomy was performed in 19 cases. Heart wounds underwent repair and complicated injuries were treated at the same time. Auto-transfusion of shed blood （2000 -4000ml） was carried out in the patients with massive haemothorax. Results Two Patients died during the operation and one died postoperatively. Conclusion Early diagnosis, prompt surgical intervention and life-threatening hemorrhage control are the key point for the cure of penetrating cardiac trauma. The auto-transfusion of shed blood plays an important role in the treatment of patients with massive haemothorax.