Wall Matthew J, Mattox Kenneth L, Wolf Dwayne A
Michael E. DeBakey Department of Surgery, Baylor College of Medicine, Houston, TX 77030, USA.
J Trauma. 2005 Jul;59(1):136-41; discussion 141-2. doi: 10.1097/01.ta.0000171466.47885.c5.
Blunt injury of the pericardium with strangulation of the heart is a rare clinical injury.
We conducted a review of clinical records and performed prospective collection of forensic data from a large urban medical examiner's office.
Ten cases of blunt injury to the pericardium were identified. All were secondary to blunt trauma. Nine of the 10 cases had associated chest wall injuries and 5 of the 10 cases had cardiac strangulation.
Pericardial lacerations are common findings at autopsy. Clinically, those that survive to the hospital have a confusing presentation. They are often diagnosed during emergent thoracotomy for hemodynamic instability. Hemodynamic deterioration associated with change in patient position may be a clue to cardiac strangulation.
钝性心包损伤伴心脏绞窄是一种罕见的临床损伤。
我们对临床记录进行了回顾，并从一个大型城市法医办公室前瞻性收集了法医数据。
共识别出10例钝性心包损伤病例。所有病例均继发于钝性创伤。10例中有9例伴有胸壁损伤，10例中有5例发生心脏绞窄。
心包撕裂伤是尸检中的常见发现。临床上，那些存活至医院的患者表现令人困惑。他们常在因血流动力学不稳定而进行的急诊开胸手术中被诊断出来。与患者体位改变相关的血流动力学恶化可能是心脏绞窄的一个线索。
