心脏及胸内大血管破裂伤的诊治探讨  

HEART AND INTRATHORACIC GREAT VESSEL RUPTURE-A RETROSPECTIVE SURVEY ON DIAGNOSIS AND TREATMENT

作　　者：柴莹[1] 陈如坤[1] 李森华[1] 吴明[1] 

机构地区：[1]浙江医科大学附属第二医院,杭州310009

出　　处：《急诊医学》1997年第4期217-219,共3页

摘　　要：目的：探讨心脏及胸内大血管破裂伤的损伤机制和救治原则。方法：对近20年心血管内外科和急诊科收治的32例病人进行了回顾性研究。结果：发现全组病人中男性占21例，女性11例，年龄36．81±11．87岁；按致伤原因分为直接穿通性损伤组9例，非穿通性损伤组7例，医源性损伤组16例；手术治疗29例，非手术治疗2例，死亡7例，其中死亡率以非穿通性损伤组为最高，达42．86％。结论：作者认为心脏及胸内大血管破裂伤的临床表现和凶险程度因其接受的损伤方式及机制形成等因素不同而表现各异，必须根据病情及危及生命的轻重缓急程度决定抢救的手段和形式，才能有效地降低死亡率。Aim: To investigate the mechanism of injury and treatment principles of heart and intrathoracic great vessel ruptures. Method: A netrospective assay covering almost 20 years is made on 32 cases of heart and intrathoracic great vessel ruptures admitted in cardiology, cardiothorax surgery and emergency departments of the Second Affiliated Hospital of Zhejiang Medical University. Results: The average age of these patients which comprise 21 male and 11 female is 36. 81 ± 11. 87 years. They are categorized into 3 groups: 9 cases of penetrating wound group, 7 cases of nonpenetrating wound group, and 16 cases of iatrogenic injury group. Twenty-nine patients received surgical treatment and 2 were treated conservatively. Seven patients died and the nonpenetrating wound group presents the highest mortality (42. 86%). Conclusion: We suggest that the severity and clinical features of heart and intrathoracic great vessel ruptures vary according to different traumatic causes and mechanism of injuries. The mortality rate won't be reduced unless proper therapy measures are selected accordingly.

关 键 词：心脏破裂伤 胸内大血管 破裂伤 诊断 救治 

分 类 号：R654.2[医药卫生—外科学] R654.3[医药卫生—临床医学]