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[穿透性心脏损伤:死亡预测因素分析]

[Penetrating cardiac injuries: analysis of the mortality predictors].

作者信息

Göz Mustafa, Cakir Omer, Eren Mehmet Nesimi

机构信息

Department of Cardiovascular Surgery, Dicle University Faculty of Medicine, Diyarbakir, Turkey.

出版信息

Ulus Travma Acil Cerrahi Derg. 2009 Jul;15(4):362-6.

Abstract

BACKGROUND

Penetrating cardiac injuries are a dramatic and lethal form of trauma. Most of these patients reach the hospital already dead or in severe shock. The prognosis is determined by early diagnosis and operation. In this study, we discuss the effects of the etiology of trauma, the state of presentation in the emergency department, and the treatment approaches on the morbidity and mortality in penetrating cardiac trauma treated in our clinic.

METHODS

Fifty-two patients treated due to penetrating cardiac injury were investigated retrospectively. Demographic characteristics, etiology of the injury, arrival time at the hospital, physical examination findings in the emergency room, diagnostic methods used, and surgical methods applied were determined along with the results.

RESULTS

The male to female ratio was 48:4, and mean age was 27.86+/-13.73. The etiology was stab injury in 46, gun shot injury in four and iatrogenic trauma in two patients. Surgery was applied in emergency condition for all cases. Cardiac injury was repaired using primary repair technique. Hospital mortality was determined as 15.4% (8 patients).

CONCLUSION

Penetrating cardiac injuries lead to shock in a very short period of time because of bleeding and/or pericardial tamponade. Early diagnosis and prompt thoracotomy are the fundamental factors affecting patient outcome after penetrating cardiac injury.

摘要

背景

穿透性心脏损伤是一种严重且致命的创伤形式。这些患者中的大多数在抵达医院时已经死亡或处于严重休克状态。预后取决于早期诊断和手术。在本研究中,我们探讨了创伤病因、急诊科就诊时的状况以及治疗方法对我院治疗的穿透性心脏创伤患者发病率和死亡率的影响。

方法

回顾性调查了52例因穿透性心脏损伤接受治疗的患者。确定了人口统计学特征、损伤病因、到达医院的时间、急诊室的体格检查结果、使用的诊断方法、应用的手术方法以及结果。

结果

男女比例为48:4,平均年龄为27.86±13.73岁。病因包括刺伤46例、枪伤4例和医源性创伤2例。所有病例均在紧急情况下进行手术。采用一期修复技术修复心脏损伤。医院死亡率为15.4%(8例患者)。

结论

穿透性心脏损伤由于出血和/或心包填塞会在很短时间内导致休克。早期诊断和及时开胸手术是影响穿透性心脏损伤患者预后的基本因素。

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