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急诊室经皮心肺支持治疗穿透性心脏损伤所致院外心脏骤停:一例报告

Out-of-hospital cardiopulmonary arrest due to penetrating cardiac injury treated by percutaneous cardiopulmonary support in the emergency room: report of a case.

作者信息

Kurimoto Yoshihiko, Kano Hitoshi, Yama Naoya, Nara Satoshi, Hase Mamoru, Asai Yasufumi

机构信息

Department of Traumatology and Critical Care Medicine, Sapporo Medical University, South 1, West 16, Sapporo 060-8543, Japan.

出版信息

Surg Today. 2007;37(3):240-2. doi: 10.1007/s00595-006-3373-8. Epub 2007 Mar 9.

Abstract

Penetrating cardiac injury tends to generally be repaired without cardiopulmonary bypass in the operating room. We herein report the case of penetrating cardiac injury repaired using percutaneous cardiopulmonary support in an emergency room. A 57-year-old man attempted suicide by stabbing himself in the left anterior chest with a knife. Although the patient suffered cardiopulmonary arrest for 7 min in the ambulance, spontaneous circulation was restored following pericardiotomy through emergency left thoracotomy in the emergency room. To prevent coronary artery injury and control the massive bleeding, percutaneous cardiopulmonary support was instituted without systemic heparinization and the cardiac injury was repaired in the emergency room. The patient was then transferred to another hospital on day 46 for further rehabilitation. Percutaneous cardiopulmonary support might be helpful for treating critical patients in an emergency room, even in the case of trauma patients.

摘要

穿透性心脏损伤通常倾向于在手术室中在非体外循环的情况下进行修复。我们在此报告一例在急诊室使用经皮心肺支持修复穿透性心脏损伤的病例。一名57岁男性用刀刺伤自己左前胸试图自杀。尽管患者在救护车上发生心脏骤停7分钟,但在急诊室通过紧急左胸开胸进行心包切开术后恢复了自主循环。为防止冠状动脉损伤并控制大量出血,在未进行全身肝素化的情况下实施经皮心肺支持,并在急诊室修复心脏损伤。患者于第46天转至另一所医院进行进一步康复治疗。经皮心肺支持可能有助于在急诊室治疗重症患者,即使是创伤患者。

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