穿透性心脏损伤4例救治体会

Experience on rescue of penetrating cardiac trauma

目的探讨穿透性心脏损伤诊断和救治措施。方法回顾分析2006年1月-2008年6月我院收治的4例穿透性心脏损伤的病例。结果3例刀刺伤所致穿透性心脏损伤全部救治成功，1例车伤肋骨骨折并发穿透性心脏损伤、心脏挫伤救治无效死亡。结论心脏穿透性损伤能否获得救治，主要与心脏损伤的部位，心脏裂口的大小，伤后就诊时间以及治疗是否及时相关，救治的关键在于及时快速的补充血容量及早期快速确诊开胸止血，术前减少不必要的检查，伤后严密地监护也是救治成功的重要环节。

Objective To investigate the diagnosis and treatment measures of penetrating cardiac trauma. Methods The clinical data of 4 patients with penetrating cardiac trauma were analyzed retrospectively, which had been treated by the general surgery department of Huidong people＇s hospital, dated from January 2006 to June 2008. Results 3 cases caused by stab wound were cured. 1 case caused by rib fracture that suffered from traffic accident died. Conclusions Penetrating cardiac trauma is the most serious trauma that endanger the life. The life and death of patients with penetrating cardiac trauma are mainly related with the location of cardiac trauma, size of cleft, the visiting time after injury, whether treated in time or not. The key of treatment lies in the cooperation of related clinics, racing against time, supplying blood volume quickly and early thoracic exploration after final diagnosis. Reducing unnecessary test before operation and rigorous monitoring are also important link.