Division of Acute Care Surgery (Trauma, Emergency Surgery and Surgical Critical Care), Department of Surgery, Keck School of Medicine, Los Angeles County+University of Southern California Medical Center, Los Angeles, CA 90033, USA.
J Pediatr Surg. 2013 Apr;48(4):745-9. doi: 10.1016/j.jpedsurg.2012.08.020.
Penetrating cardiac injuries in pediatric patients are rarely encountered. Likewise, the in-hospital outcome measures following these injuries are poorly described.
All pediatric patients (<18years) sustaining penetrating cardiac injuries between 1/2000 and 12/2010 were retrospectively identified using the trauma registry of an urban level I trauma center. Demographic and admission variables, operative findings, and hospital course were extracted. Outpatient follow-up data were obtained through chart reviews and cardiac-specific imaging studies.
During the 11-year study period, 32 of the 4569 pediatric trauma admissions (0.7%) sustained penetrating cardiac injuries. All patients were male and the majority suffered stab wounds (81.2%). The mean systolic blood pressure on admission was 28.8±52.9mmHg and the mean ISS was 46.9±27.7. Cardiac chambers involved were the right ventricle (46.9%), the left ventricle (43.8%), and the right atrium (18.8%). Overall, 9 patients (28.1%) survived to hospital discharge. Outpatient follow-up echocardiography was available for 4 patients (44.4%). An abnormal echocardiography result was found in 1 patient, demonstrating hypokinesia and tricuspid regurgitation.
Penetrating cardiac trauma is a rare injury in the pediatric population. Cardiac chambers predominantly involved are the right and left ventricles. This injury is associated with a low in-hospital survival (<30%).
儿童患者的穿透性心脏损伤很少见。同样，这些损伤后的院内预后指标也描述得很差。
使用城市一级创伤中心的创伤登记处，回顾性地确定了 2000 年 1 月至 2010 年 12 月期间所有<18 岁的>患有穿透性心脏损伤的儿科患者。提取了人口统计学和入院变量、手术结果和住院过程。通过病历回顾和心脏特定的影像学研究获得了门诊随访数据。
在 11 年的研究期间，4569 名儿科创伤住院患者中有 32 名（0.7%）患有穿透性心脏损伤。所有患者均为男性，多数为刺伤（81.2%）。入院时的平均收缩压为 28.8±52.9mmHg，ISS 平均为 46.9±27.7。受累的心脏腔室为右心室（46.9%）、左心室（43.8%）和右心房（18.8%）。总体而言，9 名患者（28.1%）存活至出院。有 4 名患者（44.4%）可进行门诊随访超声心动图检查。1 名患者的超声心动图结果异常，表现为运动障碍和三尖瓣反流。
穿透性心脏外伤在儿科人群中是一种罕见的损伤。主要受累的心脏腔室是右心室和左心室。这种损伤与院内生存率低（<30%）相关。
