心脏损伤急诊室紧急开胸救治体会

Surgical measures of emergency thoracotomy for cardiac injuries in the emergency room

目的探讨心脏损伤的急诊诊断,总结急诊室紧急开胸手术抢救的外科策略和围手术期处理经验。方法回顾分析总结31例心脏损伤急诊患者的临床资料。结果在急诊室紧急开胸手术抢救12例,存活7例（58.3%）,经急诊室紧急处理后转入胸外科治疗19例,存活15例（78.9%）。结论近年来创伤已成为35岁以下青壮年死亡的首位原因,越来越引起人们的高度重视。而心脏创伤的病死率极高,其中60%-80%死于院前,因而应当强调院前急救和医院急诊室的紧急救治。

Objective To discuss the emergency diagnosis of cardiac injuries, and summarize the experience of emergency room treatment and the surgieal measures of emergency thoraeotomy for eardiae injuries. Methods The elinieal data of 31 eardiae injury eases from October,1996 to November,2007 were analyzed. Results 12 patients received thoraeotomy in the emergency room and 7 eases survived （ 58. 3% ）. 19 patients received thoraeotomy in the operating room and 15 eases survived （78.9%）. Conclusion Injuries have always been the most important reason for the deth of the youth under 35 ,and the death rate of eardiae injury is especially high ,60% to 80% patients with cardiac injuries died in prehospital. Emphasis should be put on prehospital emergency treatments and thoraeotomy in the emergency room.