Miller F B, Shumate C R, Richardson J D
Department of Surgery, University of Louisville, School of Medicine, KY 40292.
Arch Surg. 1989 Jul;124(7):805-7; discussion 807-8. doi: 10.1001/archsurg.1989.01410070059012.
The clinical significance of various diagnostic tests and the length of monitoring required for myocardial contusion were evaluated in 172 patients. Cardiac isoenzyme levels, electrocardiograms, and echocardiograms were evaluated. Twenty-eight patients had a documented myocardial contusion based on at least one positive diagnostic study. The majority of positive studies were detected on admission and all positive tests were present within 24 hours. No patients developed positive diagnostic studies after 24 hours and, likewise, no clinical deterioration occurred late or in patients with a negative screening examination. The electrocardiogram and the clinical course were the therapeutic intervention. Cardiac isoenzyme levels had negligible significance on outcome, and the two-dimensional echocardiogram was not particularly valuable as a screening technique, If no abnormality is detected within 24 hours post injury, further investigation or monitoring does not appear warranted.
在172例患者中评估了各种诊断测试的临床意义以及心肌挫伤所需的监测时长。对心肌同工酶水平、心电图和超声心动图进行了评估。基于至少一项阳性诊断研究，28例患者被记录有心肌挫伤。大多数阳性研究在入院时被检测到，且所有阳性测试均在24小时内出现。24小时后没有患者出现阳性诊断研究，同样，晚期或筛查检查阴性的患者也没有出现临床恶化。心电图和临床病程是治疗干预措施。心肌同工酶水平对预后的意义可忽略不计，二维超声心动图作为一种筛查技术并不是特别有价值。如果在受伤后24小时内未检测到异常，则似乎无需进一步调查或监测。
