Cook Chris C, Gleason Thomas G
Department of Cardiothoracic Surgery, University of Pittsburgh Medical Center Heart, Lung, and Esophageal Surgery Institute, PUH C-800, 200 Lothrop Street, Pittsburgh, PA 15213, USA.
Surg Clin North Am. 2009 Aug;89(4):797-820, viii. doi: 10.1016/j.suc.2009.05.002.
Thoracic great vessel and cardiac trauma are characterized by anatomic location and mechanism of injury: blunt or penetrating. Management strategies are also directed by the extent and mechanism of injury. Advances in imaging and catheter-based technologies have allowed easier and more accurate diagnosis and less-invasive treatments. Although the advantages of endovascular techniques are attractive, open surgical repair remains the definitive treatment for many of these thoracic injuries. Given the increasing sophistication of these technologies and the demonstrated usefulness of a disease-oriented approach toward patient management, trauma centers have adopted a multidisciplinary team model for management of multitrauma victims. In this review, the authors detail the diagnosis and management of blunt aortic, nonaortic great vessel, blunt cardiac, and penetrating cardiac injuries.
钝性或穿透性。治疗策略也取决于损伤的程度和机制。影像学和基于导管的技术进步使得诊断更加容易和准确，治疗侵入性更小。尽管血管内技术的优势很有吸引力，但对于许多此类胸部损伤，开放手术修复仍是确定性治疗方法。鉴于这些技术日益复杂，且以疾病为导向的患者管理方法已被证明有用，创伤中心已采用多学科团队模式来管理多发伤患者。在本综述中，作者详细阐述了钝性主动脉损伤、非主动脉大血管损伤、钝性心脏损伤和穿透性心脏损伤的诊断与治疗。
