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钝性心肌挫伤31例诊治体会 被引量:1

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摘要 目的 提高钝性心肌挫伤早期诊断和治疗水平.方法 回顾性分析2000年1月至2009年12月收治的31例钝性心肌挫伤患者的临床资料.结果 入院时28例患者有不同程度的心前区疼痛症状,可同时伴有心悸、出汗、气促、血压下降,其中仅3例表现为心绞痛,并向左肩部放射.心肌酶谱检查肌酸激酶、肌酸激酶同工酶-MB、丙氨酸氨基转移酶、乳酸脱氢酶均显著升高.心肌肌钙蛋白T或心肌肌钙蛋白Ⅰ均阳性.超声心动图检查20例,有阳性发现17例,其中心包积液7例.31例钝性心肌挫伤患者中保守治疗27例,手术治疗4例.治愈29例,死亡2例,病死率为6.5%(2/31),其中1例为心肌广泛挫伤、大面积心肌坏死出血,保守治疗无效死亡,1例心包积血并严重心肌挫伤而行开胸探查术,术中心脏骤停死亡.本组病例血清心肌酶学指标均在2周内恢复正常.在有心电图改变的患者中,26例在1个月内恢复窦性心律.随访中发现室壁瘤2例,缩窄性心包炎1例.结论 在胸部外伤中,要高度警惕心肌挫伤的存在,提高早期诊断率,心肌肌钙蛋白在早期诊断中具有重要价值,早期诊断、合理救治是提高治愈率的关键.
出处 《中国医师进修杂志》 2011年第2期62-63,共2页 Chinese Journal of Postgraduates of Medicine
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参考文献5

  • 1Holanda MS,Dom ínguez MJ,L ó pez-Espadas F,et al.Cardiac contusion following blunt chest trauma.Eur J Emerg Med,2006,13(6):373-376.
  • 2Konijn AJ,Egbers PH,Kuiper MA.Pneumopericardium should be considered with electrocardiogram changes after blunt chest trauma:a case report.J Med Case Reports,2008 (2):100.
  • 3贾佳,李力群.钝性胸部外伤心脏损伤的诊断治疗进展[J].中国急救医学,2003,23(5):326-328. 被引量:4
  • 4Henderson VJ,Smith RS,Fry WR,et al.Cardiac injuries:analysis of an unselected series of 251 cases.J Trauma,1994,36 (3):341-348.
  • 5Velmahos GC,Karaiskakis M,Salim A,et al.Normal electrocardiography and serum troponin Ⅰ levels preclude the presence of clinically significant blunt cardiac injury.J Trauma,2003,54(1):45-50.

二级参考文献24

  • 1Cooper GJ, Maynard RL, Peace BP, et al. Cardiovascular distortion in experimental nonpenetrating ( ? ) chest impacts [ J ]. J Trauma, 1984, 24 :188.
  • 2Symbas PN. Cardiac trauma[J]. Am Heart J, 1976,92(3) :387 - 396.
  • 3Perchinsky MJ, Long WB, Jonathan GH. Blunt cardiac rupture[J]. Arch Surg, 1995,130(8) :852 - 857.
  • 4Moosikasuwan JB, Thomas JM, Buchman TG. Myocardial infarction as a complication of injury[J]. Journal of the American College of Surgeons (UNITED STATES), 2000,190(6) :665 - 670.
  • 5Chun JH, Lee SC, Gwon HC, et al. Left main coronary artery dissection after blunt chest trauma presented as acute anterior myocardial infarction:assessment by intravascular ultrasound: a case report[ J]. Journal of Korean Medical Science, 1998,13(3) :325 - 327.
  • 6Hirose H. Posttraumatic right coronary artery aneurysm complicated with acute myocardial infarction shortly after blunt chest trauma[ J ]. Journal of Trauma, 1997,43(5) :859 - 861.
  • 7Gay W. Blunt trauma to the heart and great vessels[ J]. Surgery, 1982,91(5):507- 509.
  • 8Amorim MJ. Atrioventricular septal defect following blunt chest trauma[J]. European Journal of Cardio - Thoracic Surgery, 1999, 16(6) :679 -682.
  • 9Mahy IR, al - Mohammad A, Cargill RI. Left atrial thrombus as an early consequence of blunt chest trauma[ J]. Heart, 1998,79(2) : 198 - 199.
  • 10Camp PC, Shackford SR. Outcome after blunt traumatic thoracic aortic laceration: identification of a high - risk cohort [ J ]. Western Trauma Association Multicenter Study Group Journal of Trauma, 1997,43(3):413-422.

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