Kaiser M E, Birnbaum D E
Klinik und Poliklinik für Herz-, Thorax- und herznahe Gefässchirurgie, Klinikum der Universität, Franz-Josef-Strauss-Allee 11, 93042 Regensburg.
Kongressbd Dtsch Ges Chir Kongr. 2001;118:568-71.
Injuries of the heart are present in 7-12% of all thoracic trauma cases. Most of these (80%) are polytrauma patients. The mechanism of the accident, the localisation of injuries, the physical condition of the patients and the skills of the hospital stuff are determinant factors for the outcome. Hemodynamic instability needs an urgent echocardiography, signs of an obstructive pericardial hematoma and/or progressive bleeding require an urgent operation using a left lateral or mediosternal approach. ECC and cell saving should be available. The contusion of the heart is monitored by ECG and Troponin tests. The application of a "mini" heart-lung machine in difficult situations could be very useful.
在所有胸部创伤病例中，心脏损伤占7% - 12%。其中大多数（80%）为多发伤患者。事故机制、损伤部位、患者身体状况以及医院工作人员的技术水平是决定预后的因素。血流动力学不稳定需要紧急进行超声心动图检查，存在心包填塞血肿和/或进行性出血的迹象则需要通过左侧或胸骨旁入路进行紧急手术。应具备体外循环和血液回收设备。通过心电图和肌钙蛋白检测监测心脏挫伤情况。在困难情况下应用“微型”心肺机可能非常有用。
