Sigurðardóttir Anna, Stefánsson Sigurjón Örn, Jóhannesdóttir Bergrós Kristín, Gudbjartsson Tomas
Laeknabladid. 2015 Dec;101(12):575-8. doi: 10.17992/lbl.2015.12.55.
Penetrating cardiac injuries usually result in an excessive bleeding and a cardiac tamponade with a very high mortality. If patients reach hospital alive, or within 15 minutes after no signs of life are found, an emergency department thoracotomy (EDT) can be indicated. However, the indications and outcome of this procedure have been debated. We report a 40 year old male that sustained a cardiac stab injury, causing a cardiac tamponade and a circulatory arrest. By performing an EDT with a pericardiotomy and direct cardiac massage, his circulation could be restored and the perforation of the heart sutured. Twelve months later the patient is in good health. This case shows that an EDT can be life saving in patients with penetrating cardiac injuries.
穿透性心脏损伤通常会导致大量出血和心脏压塞，死亡率极高。如果患者在尚有生命体征时被送达医院，或在被判定无生命体征后15分钟内被送达医院，则可考虑进行急诊室开胸手术（EDT）。然而，该手术的适应症和效果一直存在争议。我们报告一例40岁男性，其遭受心脏刺伤，导致心脏压塞和循环骤停。通过实施心包切开术和直接心脏按摩的急诊室开胸手术，恢复了他的循环，并对心脏穿孔进行了缝合。十二个月后，患者身体健康。该病例表明，急诊室开胸手术对于穿透性心脏损伤患者可能挽救生命。
