心脏创伤22例的诊断和处理  

Diagnosis and Management of Cardiac Trauma

作　　者：蒋振斌 周光华 范清 陈志强 

出　　处：《中华创伤杂志》1995年第6期359-360,共2页Chinese Journal of Trauma

摘　　要：报告２２例心脏损伤，其中穿入性１１例，医源性６例，闭合性５例。１６例行急诊手术，包括缝合心脏裂口，清除心肌异物，闭式二尖瓣分离，清除心包腔血块。择期和Ⅱ期手术７例，其中二尖瓣替换术３例，三尖瓣替换术２例，主动脉瓣成形术１例，心室间隔缺损缝补术１例。诊断主要依据为：大量失血，心脏压塞，心脏杂音及心包穿刺结果。条件允许时可行超声心动图和床旁摄片检查。２２例均经手术治疗，２１例痊愈出院，死亡１例，死亡率４．５％。From 1954 to 1994, 22 patients with trauma of the heart were treated surgically, The causes of traumatic injuries were penetrating wounds in 11 cases, nonpenetrating traumatic injuries in 6 cases and medical cause in 6 cases. The indications for operation were cardiac tamponade, massive hemorrhage, foreign bodies and blunt thoracic trauma causing valve dysfunction due to disruption of the papillary muscles or chordae tendineac or detachment of the leaflet from the anulus and septal perforation. All patients underwent pericardicentesis and emergency operation for hemostasis, evacuation of blood clot and foreign body, closed mitral commissurotomy, replacement of valve and repair of ventrical septum defect. One of the operated patients died accounting for 4.5% of the all operated. Pericardicentesis is preferable for improving hemodynamics as a preoperative measure. But cardiac injury with cardiac temponade or massive hemorrhage always requires immediate operation. (Original article on page 359)

关 键 词：心脏 创伤 诊断 治疗 

分 类 号：R654.2[医药卫生—外科学]