31例心脏锐器伤的救治

Treatment of 31 cases of stabbing cardiac injuries

目的 总结心脏锐器伤的救治经验 ,探讨影响死亡的因素。 方法 对 1983～ 1998年以来收治的 31例心脏锐器伤患者 ,根据到达急诊室的临床生理状况 ,按Ivatury分类法划分为 4组 ,全部进行了开胸手术治疗 ,其中急诊室开胸手术 11例 ,手术室开胸手术 2 0例。 结果 全组死亡 8例 ,死亡率 2 6 %。Ⅰ组死亡 2例 ( 2 2 ) ,Ⅱ组死亡 5例 ( 5 13) ,Ⅲ组死亡 1例 ( 1 13) ,Ⅳ组无死亡 ( 0 3)。急诊室开胸手术死亡 6例 ( 6 11) ,手术室开胸手术死亡 2例 ( 2 2 0 )。 结论 要提高心脏锐器伤的抢救成功率 ,应加强院前救治和转运 ,缩短受伤到手术时间 ,对无生命征、濒死的患者应行急诊室开胸手术。

Objective To summarize the experience in treatment of 31 cases of stabbing cardiac injuries and to determine the risk factors for death. Methods From 1983 to 1998, 31 patients with stabbing cardiac injuries were treated in our hospital. They were divided into 4 groups according to their clinical physiological status at arrival of emergency room. All patients were undergone thoracotomy, 11 patients in emergency room, 20 patients in operation room. Results There were 8 deaths with mortality rate of 26%. In 11 patients, 6 undergone thoracotomy in emergency room were died. Of 20 patients, 2 undergone thoracotomy in operating room were died. Conclusions In order to improve treatment effectiveness of stabbing cardiac injuries, the period from being injured to operation should be as short as possible. It is also very important that patients should be divided into different groups in emergency room.