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心脏意外和医源性异物损伤的管理——病例系列

Management of Accidental and Iatrogenic Foreign Body Injuries to Heart- Case Series.

作者信息

Kumar Rupesh, Rana Sandeep Singh, Kumar Sanjay, Das Deepanwita, Datta Monalisa

机构信息

Assistant Professor, Advanced Cardiac Center, Cardiothoracic and Vascular Surgery, Postgraduate Institute of Medical Education and Research, Chandigarh, India.

Professor, Department of Advanced Cardiac Center, Cardiothoracic and Vascular Surgery, Postgraduate Institute of Medical Education and Research, Chandigarh, India.

出版信息

J Clin Diagn Res. 2017 Mar;11(3):PE01-PE04. doi: 10.7860/JCDR/2017/23847.9336. Epub 2017 Mar 1.

Abstract

Accidental and iatrogenic foreign body injuries to heart require immediate attention and its timely management is cornerstone to the life of an individual. We describe in detail five cases of Accidental and iatrogenic foreign body injuries to heart encountered between January 2013 and July 2016. Our series included the following: needle stick injury to the right atrium (1 case) retained catheter fragments in the distal main pulmonary artery (1 case), right ventricle injury during catheterisation study (1 case), right ventricle injury during permanent pacemaker lead placement (1 case), device migration in atrial septal defect closure (1 case). Foreign bodies were removed from the cardiac cavities when the patient presented with features of infection (1 case), cardiac tamponade (2 case), anxiety (1 case), and haemodynamic instability (1 case). The management of accidental and iatrogenic foreign body injuries to heart requires immediate attention. Foreign bodies in the heart should be removed irrespective of their location and symptomatology. Asymptomatic foreign bodies diagnosed immediately after the injury with associated risk factors should be removed; asymptomatic foreign bodies without associated risks factors or diagnosed accidentally after the injury also need surgical intervention to allay fears of anxiety in patient and their relatives, to prevent any late complications and also for medico-legal purpose.

摘要

心脏的意外和医源性异物损伤需要立即关注,及时处理是关乎个人生命的基石。我们详细描述了2013年1月至2016年7月间遇到的5例心脏意外和医源性异物损伤病例。我们的病例系列包括以下情况:右心房针刺伤(1例)、远端主肺动脉内残留导管碎片(1例)、心导管检查期间右心室损伤(1例)、永久起搏器导线置入期间右心室损伤(1例)、房间隔缺损封堵时装置移位(1例)。当患者出现感染特征(1例)、心脏压塞(2例)、焦虑(1例)和血流动力学不稳定(1例)时,从心脏腔室中取出了异物。心脏意外和医源性异物损伤的处理需要立即关注。无论心脏内异物的位置和症状如何,均应予以取出。受伤后立即诊断出的有相关危险因素的无症状异物应取出;无相关危险因素或受伤后偶然诊断出的无症状异物也需要手术干预,以减轻患者及其亲属的焦虑恐惧,预防任何晚期并发症,同时也是出于医疗法律目的。

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