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创伤性心包积液的外科急救处理 被引量:3

Management of traumatic pericardiac effusion with emergency surgery
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摘要 目的总结创伤性心包积液的外科急诊救治的临床经验。方法回顾性分析2007年7月至2010年7月间,上海两所三甲医院所收治的创伤性心包积液患者的病史资料和外科治疗效果。结果总计有26例发生创伤性心包积液。16例刀刺伤,10例交通伤。中等量以上积液者17例,少量积液者9例,7例发生心包填塞。心脏损伤17例,心包破裂2例,原因未定者7例。手术行心脏修补术17例,心包开窗术4例,心包穿刺术2例,无特殊处理者3例。死亡5例,其中3例手术失败,1例死于延迟性心脏破裂,1例死于支气管肺动脉瘘和低氧血症。结论创伤性心包积液与心脏损伤密切相关,多数需手术治疗。早期诊断和及时手术救治是挽救生命的关键。 Objectives To review the clinical experiences of management of traumatic pericardiac effusion with emergency surgery. Methods Clinical data and surgical results of 26 patients with traumatic pericardiac effusion admitted in authors' hospitals from July 2007 to July 2010 were retrospectively reviewed. Results Among 26 cases reviewed, causes of injury were stab wound in 16 and vehicle accident in 10. Moderate effusion was detected in 17 cases and mild in 9 cases. 7 cases suffered from cardiac temponade. Cardiac injury was demonstrated in 17 cases, pericardium rupture in 2, and undetermined cause was demonstrated in 7 cases. Seventeen cases underwent cardiac repair, 4 underwent pericardium fenestration, 2 underwent pericardiocentesis, and 3 were without any special treatment. Five patients died, among whom 3 were attributed to surgical failure and 1 was attributed to delayed cardiac rupture; 1 case died from bronchial pulmonary artery fistula and hyoxemia. Conclusion Traumatic pericardiac effusion is closely related to cardiac injury, mostly requiring surgical treatment. Early diagnosis and emergency operation is the key to rescue lives.
出处 《同济大学学报(医学版)》 CAS 2011年第4期77-80,共4页 Journal of Tongji University(Medical Science)
关键词 创伤 心包积液 心脏损伤 trauma pericardiac effusion cardiac injury
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参考文献9

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