穿透性心脏损伤的诊断与治疗(附21例报告)

The Diagnosis and Surgical Treatment of Penetrating Cardiac Trauma

目的探讨心脏穿透伤外科诊治中的原则，急诊室剖胸的指征。方法位于心表投影区的损伤应警惕心脏穿透伤的发生。手术切口选择，可根据伤道情况采用右侧或左侧前外侧切口剖胸。5例濒死病人施行了急诊室剖胸，2例存活，3例死亡。结果21例中枪伤5例，死亡3例；刃器伤16例，死亡2例。结论对心脏穿透伤病人应抓紧时机，提高认识，及时明确诊断，根据病情和条件，采用相应积极而有效的治疗方法。

Objective To present the clinical experience in managing patients with penetrating cardiac trauma.Methods There wer 21 cases with penetrating cardiac trauma, 5 of them, who had been moribund, received thoracotomy in the emergency department immediately- -2 survived while 3 died as the rerults.Results Among the 21 cases, 6 were gunshot-wounds with 3 death;16 were stabwounds with 2 death. Conclusion Thoracic wounds locating in the cardiac projective area should remind us of the possibility of cardiac penetrating trauma. To confirm the correct diagnosis and its relative treatment are very essential to a thoracic surgeon.Left or right anterior lateral thoracotomy should be applied according to the location of cardiac trauma.