心脏大血管损伤的急诊处理

The Emergency Treatment of the Cardiovascular Trauma

目的 总结心脏大血管损伤的临床救治经验。方法 回顾性分析 195 3年～ 1998年 2 7例心血管损伤的外科治疗和结果。结果 3例手术死亡 ,死亡率为 11.1% ,其余病人均痊愈出院。结论 心血管损伤的早期诊断和急诊处理是提高治愈率的关键。胸内活动性出血及急性心脏压塞必须急诊剖胸手术。对于闭合性创伤性室缺和心瓣膜损伤 ,除非有难以控制的进行性心力衰竭 ,手术时机一般选择在伤后

? Objective To review the surgical experience of cardiovascular trauma.Methods Twenty seven patients with cardiovascular trauma were treated surgically from 1953 to 1998. Results There were 3 operative deaths,with a mortality of 11.1%.Others recovered smoothly. Conclusion Early diagnosis and treatment are the key to manage cardiovascular trauma.An emergency thoracotomy is required to intra thoracic exsanguinating hemorrhage or acute pericardial tamponade.To blunt traumatic VSD and valvular insufficiency,unless accompanying a uncontrolled progressive heart failure,the proper time for operation would be 3 months later. 〔