濒死的失血休克型心脏穿透伤急诊室剖胸成功1例报告

Successful resuscitation by emergency room thoractomy in a patient in agonal state with hemorrhagic shock resulting from penetrating cardiac injury

患者男,23岁,被刀刺伤,左胸第4肋间4 cm伤口,血压0/0 kPa,处于濒死状态。伤后16 min经左前外侧切口第4肋间行急诊室剖胸术,探查见:胸腔积血2 500 ml,心包4 cm伤口,心脏2 cm伤口,左肺上叶5 cm伤口。4 min内成功地用心包做垫片缝合心脏3针。病人8 d后痊愈出院。

A 23-year-old male patient, who was stabbed in the left chest at the fourth intercostal space leaving a 4-cm wound, was in agonal state with blood pressure of 0/0 kPa when admitted. The patient underwent emergency room thoractomy on stretcher through the left fourth intercostal anterior lateral incision16 min after injury. The exploration revealed 2 500 ml blood in the plural cavity, 4-cm wound in the pericardium, 2-cm wound in the right ventricle of the heart without asystole, and 5-cm wound in the left upper lobe of the lung. Within 4 min the wound in the heart was sutured with the pericardium as the backing. The patient was discharged with full recovery 8 d after injury.