心脏大血管损伤并急性心包压塞的外科治疗(附15例报告)

Surgical management of cardiac and great vessels injury associated with acute cardiac tamponade (A report of 15 cases)

目的心脏大血管损伤并急性心包压塞的救治体会。方法通过对15例心脏大血管损伤并急性心包压塞患者的救治体会,描述抢救过程及方法。结果术中发现右心室贯通伤2例,左心室心肌裂伤5例,右心室心肌刺裂伤5例,主动脉弓穿透破裂1例,纵隔心包内钢钎异物存留1例,单纯心包破裂1例,8例合并有肺裂伤。心肌破裂口在0.3cm～1.5cm13例,2.5cm1例,1例主动脉破裂口约0.6cm。15例中14例治愈出院,1例右心室心脏贯通伤患者死于术中失血性休克。结论对心脏大血管损伤并急性心包压塞的患者,尽早手术探查止血,清除心包内的积血、凝血块、解除心脏压迫,是最有效的抢救手段。

Objative To summarize the resure of cardio great trauma associated with acute cardiac tamponade. Methods Fifteen cases with caridio great vessels with acute cardiac tamponade were analyzed. Results Among 15 cases 14 cases were cured, one case died of Hemorrhagic shock. Of these 15 patients,.right ventricular penetrating wound was in 2 cases,.left ventricular and right ventricular myocardial injury were in 5 and 8 cases, aortic arch rupture was 1 case, and 8 cases were complicated lung injury. There 13 patients with The myocardial rupture were from 0.3 cm to 1.5 cm in 13 cases,.2.5 cm in one case,.0.6 cm in aorta. Conclusion To heart and great vessel injury combined with acute cardiac tamponade,.the best treatment is immediate operation as early as possible and stop bleeding.