单纯心脏闭合性钝击伤(附四例报告)

Simple Cardiac Close dull Injnry

本文报告四例单纯性心脏内部结构损伤的患者,其中二例瓣膜撕裂、一例瓣膜穿孔、一例腱索断裂。伤后首发症状为胸痛、胸闷、心慌、头晕或晕厥,病程进展中危害最大的是伤后3—6月出现继发心衰。其中三例因心衰发展为难治型而施紧急手术,二例换瓣后康复,一例术后病理检查证明是马凡氏综合征者术中死于室颤。文章简述了心脏闭合伤的概况,分析了发病机制,总结了诊治的三点体会。

The clinical analysis of 4 cases of simple cardiac close dull injury were reported: 2 cases of cardiac valves rupture, 1 case of perforation of valves, 1 case of rupture of chordae tendined. The early symptoms after cardiac close injury were: chest pain, chest distress, palpitation, giddiness or faintess. Secondary heart failure, occuring 3-6 month after injury, was considered to be a most dangerous factor for the patient. Among them, 3 cases accepted emergent opetation due to intractable heart failure, 2 cases recovered after valve replacement, 1 case died from VF in operation, which was proved as Marfan's syndrome by postmortem pathology. This presentation has reviewed the general outline of the disease. The mechanism of the disease was analysed. Experiences on diagnosis and treatment were discussed.