73例心脏及心包内大血管创伤的急救  

First Aid Treatment for Traumas to the Heart and Intrapericardial Great Vessels: A Report of 73 Cases

作　　者：冯树新[1,2] 冯树林 孟庆刚[1,2] 杨国华 李兵[1,2] 朱安龙 

机构地区：[1]哈尔滨医科大学附属第一医院创伤外科 [2]黑龙江省服装鞋帽工业公司职工医院外科

出　　处：《中华创伤杂志》1997年第4期209-211,共3页Chinese Journal of Trauma

摘　　要：目的：报告心脏及心包内大血管创伤７３例的救治体会，旨在提高早期诊断和手术治疗水平．方法：本组病例根据外伤史、临床征象进行早期诊断，部分病例结合床旁胸部Ｘ线和超声心动图或心包穿刺确立诊断．全组均经手术治疗，其中穿透伤６５例，胸部闭合伤所致心脏损伤４例，医源性心脏损伤４例．２０例危重伤员直接送入手术室手术，２例入病房时因心脏停搏在监护室紧急手术，２例医源性损伤因危重而就地于导管室施术．本组其余病例分别于０．５～５小时内手术．结果：本组痊愈６８例，治愈率９３．２％；死亡５例，手术死亡率６．８％．结论：心脏大血管救治成功的关键在于尽早明确诊断，快速急救，选择适当的手术方法和途径．Aim: To report the experience of diagnosis and treatment of cardiovascular trauma in 73 cases in order to improve the level of early diagnosis and operating treatment. Methods: The early disgnosis was obtained according to the history of trauma and clinical signs. In some patients, chest X ray, echocardiogram and pericardiocentesis were needed. All patients underwent surgical treatment. Penetrating wounds were found in 65 cases, nonpenetrating injuries in 4 cases and iatrogenic causes in 4 cases. Twenty severely injured patients were treated operatively in no time on admission. Two cases of sudden arrest of heart beat were operated upon in ICU. Two cases of severe iatrogenic injury were operated upon in catheter room. The others were treated surgically from 0.5 to 5 hours. Results: In this series 68 cases cured (93.2%). Five cases died (6.8%). Conclusion: Early diagnosis, fast first aid treatment and reasonable choices of operating procedures are important factors influencing emergency treatment of cardiovascular trauma.

关 键 词：心脏 大血管 创伤 急救 外科手术 

分 类 号：R654.059.7[医药卫生—外科学] R605.97[医药卫生—临床医学]