47例心脏创伤临床分析

THE CLINICAL ANALYSIS OF CARDIAC INJURY: A REPORT OF 47 CASES

目的：报告47例心脏创伤诊治情况，总结抢救过程中得失经验、吸取教训，旨意在提高抢救治疗水平。方法：回顾性统计分析本院1990年至今诊断有心脏创伤的病例。结果：全组47例，闭合性心脏创伤29例，穿透性心脏创伤18例。共行开胸手术16例，其中7例于急救室进行，生存2例；9例于手术室进行，生存5例。31例心跳骤停未行开胸手术，而行心外按压复苏，无一生存。另外，5例因忽略或漏诊心脏创伤，死于其它手术中。结论：严重的闭合性心脏损伤和穿透性心脏创伤实行早期开胸手术是抢救治疗的关键，心外按压法对抢救心脏创伤所致的心跳骤停是无效的，忽略或漏诊心脏创伤可致严重后果。

Retrospective analysis of all cases of cardiac injury during the last 8 years in the my hospital was carried out. Penetrating cardiac injuries were found in 18 cases, non-penetrating one in 31 cases, 16 patients underwent thoracotomy. 9 cases were performed in emergency rcom, 3 cases survived; another 7 cases were performed in operation room, 4 survived. Cardiopulmonary resuscitation was performed in 26 cases, none survived; and 5 cases of cardiac injury were missed diagnosis, all died in other operation. Emergency thoracotomy is the key to manage the severe cardiac injury. Cardiopulmonary resuscitation is not adoptive in sudden arrest of heart beat caused by cardiac injury. Missed diagnosis of cardiac injury will lead severe consequences.