心脏刀刺伤的外科治疗（附8例报告）  

SURGICAL TREATMENT FOR STABBED HEART

作　　者：张万青[1] 何悦概[1] 钱定一[1] 张光休[1] 苏廷宝[1] 李杰[1] 程可洛[1] 

机构地区：[1]广东医学院附属医院胸心外科

出　　处：《广东医学院学报》1995年第4期299-301,共3页Journal of Guangdong Medical College

摘　　要：１９９０年７月至１９９４年７月，我科遇心脏刀刺伤８例，其中除１倒死于急诊科外，另７例均行急诊手术，均抢救成功且已恢复工作。凡心前区有伤口，且短期内出现重度低血压者，心脏刀刺伤可能性极大，不应作过多检查和不必要搬动，尤其远距离运送，而应紧急手术。如确无手术条件，则应抗休克、剑突下心包穿刺或切开引流后再运送到有条件医院手术。对短期内心跳骤停者亦应积极手术。行创伤侧的前胸外侧切口径路有利于手术视野的显露。术中先处理对生命威胁最大的刺伤部位，心室裂口可用带垫丝线＂Ｕ＂字结合外加＂８＂字缝合，心房可用丝线连续缝合，主动脉小裂口可行双荷包缝合。并对自体胸血回输作了简要的讨论。Eight patients with stabbed heart were treated,7 of them survived and recovered well after emergency operation,and one died.It should be stressed that any patients with wound on precordial region,especialy accompanied by serious hypotension in a very short time, had most likely stahbed heart, and should be given an emergency operation avoiding any unnecessary examination or movement. If they couldn't be operated on at an tnferior hospital,the patients Should first be given a treatment of countershock,pericardiocentesis, or pericardiotomy and open drainage, then sent to a superior hospital to be operated on,If,the patients had cardiac arrest,an operation should be given too. An incision along lateral prothorax on the wounded-side would help the exposure of the operation. During operation,the stabbed area should first be dealt with as it would be lifethreatening. The ventrical open wound can be sealed by silk with a gasket by means of figure'U' or an additional figure'8'.The atrial wound could sequentially be sutured by silk,Small cut in the aorta can be sealed with two purse-thring sutures. The autotransfusion of thoracic hematocele is also briefly discussed.

关 键 词：心脏损伤/创伤性 外科手术 心脏/外科手术 

分 类 号：R654.2[医药卫生—外科学]