Kiladze M A, Chkhetia N Sh, Vasadze G K, Mindadze K A
Georgian Med News. 2009 Apr(169):15-7.
The penetrating cardiac injury after the chest stab wound in 33 year old patient is described. The following clinical signs indicated suspected cardiac injury: localization of injury to the region of the heart, the signs of acute bleeding and cardiac tamponade, which was also confirmed by echocardiography. During urgent thoracotomy with additional sternotomy the right ventricle injury of 1,5 cm of length was found, which required 5 stitches for repair of defect and complete hemostasis. The temporary cardiac arrest (40-50 sec) has occurred during cardiography and internal cardiac massage was performed to restore the normal cardiac rhythm. Postoperative course was uneventful and patient on the 10th day after admission was discharged from the hospital. The successful outcome of treatment of this severe group of patients could be achieved by maintenance of the following fundamental principles: rapid transport of patients to the nearest hospital, maximum rapidity in establishment of diagnosis and highly qualified urgent surgical intervention. Echocardiography is the most informative and quick method of noninvasive diagnostics of penetrating cardiac injury.
描述了一名33岁患者胸部刺伤后发生的穿透性心脏损伤。以下临床体征提示疑似心脏损伤:损伤部位位于心脏区域、急性出血和心脏压塞体征,超声心动图也证实了这一点。在紧急开胸并附加胸骨切开术期间,发现右心室有一处1.5厘米长的损伤,需要缝合5针以修复缺损并实现完全止血。在心脏造影期间发生了短暂心脏骤停(40 - 50秒),并进行了心脏内按摩以恢复正常心律。术后病程平稳,患者入院后第10天出院。通过遵循以下基本原则可实现这类重症患者的成功治疗:将患者快速转运至最近的医院、尽快确诊并进行高素质的紧急手术干预。超声心动图是诊断穿透性心脏损伤最具信息量且快速的无创诊断方法。