Mataraci Ilker, Polat Adil, Cevirme Deniz, Büyükbayrak Fuat, Saşmazel Ahmet, Tuncer Eylem, Songur Murat, Erentuğ Vedat, Kirali Kaan, Yakut Cevat
Kartal Koşuyolu High Graduate Education and Research Hospital, Istanbul, Turkey.
Ulus Travma Acil Cerrahi Derg. 2010 Jan;16(1):54-8.
Our aim was to express the importance of emergency diagnosis and surgical approach in penetrating cardiac trauma patients.
Koşuyolu Heart and Research Hospital moved to its new location in Cevizli Kartal in June 2005. Due to its close proximity to the main roads of the city, the number of trauma cases has increased tremendously. We have retrospectively examined our penetrating cardiac trauma cases treated between June 2005 and September 2008.
Twenty-six trauma cases were admitted to our clinic with penetrating cardiac trauma. Twenty of them were operated on an emergency basis. One (5%) had a gunshot wound while the other 19 (95%) had stab wounds. Four were female (20%) and 16 were male (80%). Average age of the patients was 24.9+/-10.1 (12-49) years. Telecardiography and transthoracic echocardiography were used for diagnosis. Surgical approaches were median sternotomy in 14 and left anterolateral thoracotomy in 6 cases. The right ventricle was damaged in 12, left ventricle in 7 and pulmonary artery in 1. Additionally, 5 patients had lung injury, 1 had brachiocephalic vein injury and 1 had coronary artery injury. One patient was re-explored for bleeding. There were two mortalities (10%) postoperatively.
Rapid transfer to the emergency department, accurate and quick diagnosis and aggressive surgical approach will increase survival in penetrating cardiac trauma.
我们的目的是强调穿透性心脏创伤患者紧急诊断及手术方法的重要性。
科叙约卢心脏与研究医院于2005年6月迁至位于切维兹利卡尔塔尔的新址。由于其靠近城市主要道路,创伤病例数量大幅增加。我们回顾性研究了2005年6月至2008年9月期间收治的穿透性心脏创伤病例。
26例创伤患者因穿透性心脏创伤入住我院。其中20例接受了急诊手术。1例(5%)为枪伤,其余19例(95%)为刺伤。4例为女性(20%),16例为男性(80%)。患者平均年龄为24.9±10.1(12 - 49)岁。采用心电图和经胸超声心动图进行诊断。手术方式为正中胸骨切开术14例,左前外侧开胸术6例。右心室损伤12例,左心室损伤7例,肺动脉损伤1例。此外,5例患者合并肺损伤,1例合并头臂静脉损伤,1例合并冠状动脉损伤。1例患者因出血接受再次探查。术后有2例死亡(10%)。
快速转运至急诊科、准确快速的诊断及积极的手术方法将提高穿透性心脏创伤患者的生存率。