穿透性心脏损伤14例救治与分析  

Management of 14 Cases of Penetrating Cardiac Injuries

作　　者：董书强[1] 谢鹏禄[1] 张兆喻[1] 钱振[1] 曹文峰[1] 孟毅[1] 董逸飞[1] 

机构地区：[1]兰州军区兰州总医院心血管外科,甘肃兰州730050

出　　处：《医学临床研究》2013年第3期533-534,537,共3页Journal of Clinical Research

摘　　要：【目的】总结14例心脏穿透性损伤抢救与诊疗经验。【方法】本组14例中刀刺伤12例，枪击伤2例，男13例，女1例，年龄16～48（30．4土10．2）岁。从受伤到就诊时间20～165（57．8±41．7）min。创口大多在心脏损伤危险区。就诊时伤情分型：无生命体征型1例、严重不稳定型6例、心包压塞型4例、胸腹联合伤型2例、基本稳定型1例。所有伤者在急诊全麻下手术治疗。【结果】3例死亡（病死率21．4％）。11例治愈，其中1例患者3个月后因室间隔肌部缺损经皮封堵治愈。【结论】心脏穿透伤仍有着较高的死亡率，抢救成功的关键在于迅速而准确的诊断、恰当而简便的手术入路、严格遵循精确的修补技术。[Objective] To retrospectively analyze 14 cases of penetrating cardiac injuries, and to summa- rize the experience of rescue, diagnosis and treatment. [Methods] Among 14 patients in the group, 12 patients were stab wound（85.7%） and 2 patients（14.3%） were gunshot injury. There were 13 males and 1 female. The mean age was 16-48 years old（mean 30.44±10.2 years old）. The time from injury to admission was 20- 165rain[mean （57.8±41.7）mini. The trauma was mostly in the danger area of heart injury. According to the pathological condition, one patient was the type of absence of vital signs, and 6 patients were critically unsta- ble-type, and 4 patients were cardiac tamponade type, and 2 patients were combined thoraco abdominal wound type, and one patient was basically stable-type. All patients underwent the emergency operation under general anesthesia. [Results] Three patients died, and the mortality rate was 21.4%. Eleven patients were cured. A- mong them, one patient underwent percutaneous closure for muscular ventricular septal defect after 3 months. [Conclusion] Penetrating cardiac injure is a highly lethal injury. Prompt and correct diagnosis, proper and simple surgical approach and strict and precise repairing technique are the key to the successful rescue.

关 键 词：心脏损伤 治疗 

分 类 号：R654[医药卫生—外科学]