29例闭合性心脏创伤临床分析

The clinical analysis of non-penetrating cardiac injury:a report of 29 cases

目的：报告２９例闭合性心脏创伤诊治情况，总结抢救过程中得失经验、吸取教训，旨在提高抢救治疗水平。方法：回顾性统计分析两家医院１９８８年１月～１９９８年６月诊断有闭合性心脏创伤的病例。结果：全组２９例闭合性心脏创伤，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７例。１０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，３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。

Objective:To report the clinical experience of diagnosis and management for 29 cases of non penetrating cardiac injury in order to improve the level of emergency treatment.Methods:Retrospective analysis of all cases non-penetrating from Jan.1988 and Jun.1998 in the two hospital was carried out.Results:non-penetrating cardiac injuries were found in 29 cases,16 patients underwent thoracotomy,7 cases were performed in emergency room,2 cases surived;another 9 cases were performed in operation room,7 cases survived.Cardiopulmonary resuscitation was performed in 10 cases,nonesurvived;and 3 cases of cardiac injury were missed diagnosis,all died in other operation.Conclusion: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 crdiac injury will lead severe consequences.