7例心、肺锐器伤成功救治经验  

Treatment of 7 Cases of Stabbing Cardiac-lung Injuries

作　　者：王海军[1] 李勇智[1] 樊有炜 高超英[1] 周跃宁 

机构地区：[1]北京丰台医院胸外科,北京100037

出　　处：《中国现代手术学杂志》2006年第3期223-224,共2页Chinese Journal of Modern Operative Surgery

摘　　要：目的总结心、肺锐器伤的诊治体会,旨在提高早期诊断和抢救水平。方法1998年5月～2003年11月收治心、肺锐器伤7例,根据外伤史、体表伤口及临床征象进行早期诊断,均急诊行肺修补+心肌修补+心包切开引流术,其中左胸前外侧切口6例,右前外侧切口1例。结果本组术前术中输血400～2000ml,术后输血400～600ml,均止血彻底,无二次开胸。5～11d心肌酶恢复正常,5～14d拔除引流管,7例均痊愈,出院后2周、6周复诊无胸腔积液、肺不张。结论重视伤口位置和方向,早期准确诊断,选择合适切口,紧急开胸手术是心、肺锐器伤救治成功的关键。Objective To summarize the experience of diagnosis and treatment of penetrating cardiaclung injuries. Methods 7 cases of penetrating cardiac and lung injures were treated, early diagnosis were established bases on the history, wound and clinical presentation. Emergency heart and lung repair plus pericardiac drainage were carried out via left anteriolateral incision in 6 cases and right anteriolateral incision in 1 case. Result Pre- and pest-operative transfusion were 400 - 2 000 ml and 400 - 600 ml in amount respectively. Complete hemostasis achieved with once attempt. Cardiac enzymes goes down back to normal within 5 - 11 days, drainage removed within 5 - 14 days, 7 cases cured. No pleural fluid collection and pulmonary closure was observed. Conclusion Early diagnosis, right incision approach and timely intervention are the essential factors in treatment of penetrating heart and lung injuries.

关 键 词：心脏损伤 肺损伤 多处创伤 

分 类 号：R641[医药卫生—外科学]