改进心脏创伤早期救治策略的初步探讨

Improve the Strategy of Early Diagnosis and Management of Cardiac Trauma

目的总结心脏创伤的早期救治经验,探讨改进围手术期的处理策略,以提高生存率。方法回顾性分析98例心脏创伤患者的资料,分为1999～2005年和2006～2011年两组,比较两组病例数、创伤分型、诊断手段、救治方法及住院病死率等,并进行统计学检验。结果两组心脏创伤病例数、创伤分型比较差异不明显,诊断手段、救治方法构成有明显变化,2006～2011年组较1999～2005年组住院病死率明显下降(P<0.05)。结论加强院前救治及转运,及时诊断、及时开胸手术是心脏创伤早期救治的关键,心脏彩超是明确诊断的可靠手段,改进相关的救治策略可有效地提高生存率。

Objective To summarize the experience in early diagnosis and management of the patient with cardiac trauma,and study on how to improve the survival rate by way of improve the management strategy of peri-operative.Methods The clinical date of 98 cases with cardiac trauma were divided into two groups and analyzed retrospectively.Group A was those from 1999 to 2005 and Group B was from 2006 to 2011.Cases,trauma classification,diagnosis and management and mortality were compared between two groups and processed statistically.Results Compared with the Group A,the emergency cases and trauma classifications were not significant difference in the Group B with significant decrease of mortality（P0.05）.There were apparent changes in diagnosis and management in both groups.Conclusion Shortening the time between injury and treatment,strengthening first aid on the sport,promptly dignosis and operation were the keys to treat the patients with cardiac trauma.Cardiac color ultrosonography was a reliable means to make the correct diagnosis.Improve the management strategy was an effective method for improving the survival rate.