心脏大血管创伤的诊断与处理  

Diagnosis and treatment of traumatic cardiovascular injuries

作　　者：蒋振斌[1] 王哲[1] 范清[1] 周光华[1] 陈安清[1] 

机构地区：[1]复旦大学附属中山医院心脏外科,上海200032

出　　处：《中华急诊医学杂志》2003年第3期151-153,共3页Chinese Journal of Emergency Medicine

摘　　要：目的　探讨心脏大血管创伤后的急诊和外科处理。方法　回顾性分析我科 195 4年 6月～2 0 0 2年 7月收治的 4 6例心脏大血管损伤后急救处理和后遗症的病例资料 ,其中 :穿透性损伤 18例 ,闭合性损伤 14例和医源性损伤 14例 ;心脏穿破 17例 ,瓣膜破损 11例 ,心脏异物 8例 ,假性动脉瘤和动脉静瘘8例 ,右心室动脉瘤和室间隔缺损、心包缩窄和右下肺弹头各 1例。结果　 4 4例经手术治疗痊愈出院 ,死亡 2例。 1例左心房撕裂后大出血导致心脏停搏 ,抢救无效死亡。另 1例外伤引起弓降部假性动脉瘤 ,手术时出血死亡。结论　及时诊断、紧急手术 ,后遗症择期手术需在体外循环准备下手术 。Objective To explore the diagnosis and treatment of the cardiovascular injuries.Methods From 1954 to 2002,Fourty six patients with cardiovascular trauma were collected.There were 18 cases with penetrating wounds,14 cases with nonpenetrating,and 14 cases caused by iatrogenic insults.There existed penetrable heart in 17 cases,traumatic valuve in 11 cases,foreign bodies in 8 cases,pseudoaneurysm and arteriovenous fistalae in 8 cases,right ventricular aneurysm plus ventricular septal defect(VSD),late cardiac temponade plus right lung foreign bodies in 1 case,respectively.Forty six patients underwent operative treatment,including evacuation foreign bodies and drainge of pericardial cavity,replacement or repair of valves,repair or replacement pseudoaneurysm and arteriovenous fistula and sewing cardiac incision.Results Forty four patients survived and two died because of rupture heart and pseudoaneursm.Conclusion Early and timely diagnosis or elective surgical intervention can lead to gratifying effects.

关 键 词：心脏大血管创伤 诊断 处理 体外循环 

分 类 号：R654.2[医药卫生—外科学]