心脏创伤的救治对策  

Treatment for cardiac injury

作　　者：吴骏 孙林 李凤杰 杨海平 李卫强 

机构地区：[1]北京通州区潞河医院心胸外科,101149

出　　处：《心肺血管病杂志》2007年第3期146-148,共3页Journal of Cardiovascular and Pulmonary Diseases

摘　　要：目的:总结急诊救治心脏创伤的经验与疗效,探讨围手术期处理对策。方法:2002年3月至2006年11月,急诊救治心脏创伤22例(4.7例/年均,开放性穿透伤14例,闭合性钝伤8例)。21例剖胸手术[术中体外循环2例,术后应用主动脉内球囊反搏(IABP)1例,急诊室或床边剖胸2例],1例保守治疗。快速剖胸,用4～5/0prolene针线,穿涤纶垫片或毡垫条或自体心包垫片,“8”字或冠状动脉下潜行褥式缝合修补破口。结果:20例存活(手术组19例,保守组1例),无脑损伤等并发症,随访3～24个月,均恢复正常工作,死亡2例。结论:积极地剖胸手术是救治心脏创伤的有效方法,大多数手术可在非体外循环下完成,应用IABP治疗术后低心排出量综合征效果好,有条件者应尽量用自体血回输技术。Objective：To summarize the experience in diagnosis and management of cardiac injury.Method： From March 2002 to November 2006 22 cases of cardiac injury were rescued. Conservative therapy was performed on 1 case and the acute thoracotomy for repairing cardiac lesion according to the injury condition was performed in the remainders. One case with postoperative low cardiac output syndrome （LCOS） was treated with intra-aortic balloon counterpulsation （IABP）. Result：20 cases survived,2 cases died. There were no brain complications in survivors. Conclusion： Active thoracotomy is an effective method for the repair of the most cardiac injuries. Most surgery can be accomplished by off-pump. The treatment of IABP to postoperative LCOS, which can improve the patients＇ hemodynamic status, is satisfied. Blood salvage should be used during the operation.

关 键 词：心脏创伤 低心排出量综合征 主动脉内球囊反搏 心脏外科手术 

分 类 号：R654.2[医药卫生—外科学]