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“无害子弹”之旅：穿透性心脏损伤的围手术期护理

The Journey of Harmless Bullet: The Perioperative Care of Penetrating Cardiac Injury.

作者信息

Abou-Leila Ahmad, Voronov Gennadiy

机构信息

Department of Anesthesiology and Pain Management, John H. Stroger Jr. Hospital of Cook County, Chicago, IL, USA.

出版信息

Anesth Essays Res. 2017 Jul-Sep;11(3):790-793. doi: 10.4103/0259-1162.194578.

DOI:10.4103/0259-1162.194578
PMID:28928592
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC5594811/
Abstract

Traumatic injuries to the heart contribute significantly to trauma are associated with high mortality. Cardiac gunshot wounds (GSW) are considered more lethal compared to other injuries and present several unique challenges to the anesthesia management and perioperative care. We are reporting a rare case of a trauma victim who survived a GSW to the heart. We will discuss the perioperative care of penetrating cardiac injuries, the role of the anesthesia team in resuscitation, safe anesthesia induction, cardiopulmonary bypass management, and the essential role of intraoperative transesophageal echocardiogram imaging.

摘要

心脏创伤在创伤中占比重大，且与高死亡率相关。与其他损伤相比，心脏枪伤（GSW）被认为更具致命性，给麻醉管理和围手术期护理带来了诸多独特挑战。我们报告了一例心脏枪伤创伤患者存活的罕见病例。我们将讨论穿透性心脏损伤的围手术期护理、麻醉团队在复苏中的作用、安全的麻醉诱导、体外循环管理以及术中经食管超声心动图成像的重要作用。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3c8a/5594811/ee6519f4ec63/AER-11-790-g006.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3c8a/5594811/9f04dcc4747a/AER-11-790-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3c8a/5594811/8310554c24ca/AER-11-790-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3c8a/5594811/c36afda3e367/AER-11-790-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3c8a/5594811/00fee9da5194/AER-11-790-g004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3c8a/5594811/d851dd91f65e/AER-11-790-g005.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3c8a/5594811/ee6519f4ec63/AER-11-790-g006.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3c8a/5594811/9f04dcc4747a/AER-11-790-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3c8a/5594811/8310554c24ca/AER-11-790-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3c8a/5594811/c36afda3e367/AER-11-790-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3c8a/5594811/00fee9da5194/AER-11-790-g004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3c8a/5594811/d851dd91f65e/AER-11-790-g005.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3c8a/5594811/ee6519f4ec63/AER-11-790-g006.jpg

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本文引用的文献

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Evaluation of penetrating cardiac stab wounds.穿透性心脏刺伤的评估
Scand J Trauma Resusc Emerg Med. 2016 Jan 22;24:6. doi: 10.1186/s13049-015-0190-3.
2
Clinical utility of routine use of continuous transesophageal echocardiography monitoring during transvenous lead extraction procedure.经静脉导线拔除术中常规使用连续经食管超声心动图监测的临床应用价值。
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Immediate thoracotomy for penetrating injuries: ten years' experience at a Dutch level I trauma center.穿透伤的急诊开胸手术：荷兰一级创伤中心的十年经验
Eur J Trauma Emerg Surg. 2012 Oct;38(5):543-51. doi: 10.1007/s00068-012-0198-6. Epub 2012 Jun 16.
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Emergency operation for penetrating thoracic trauma in a metropolitan surgical service in South Africa.南非大都市外科服务中穿透性胸部创伤的急诊手术。
J Thorac Cardiovasc Surg. 2011 Sep;142(3):563-8. doi: 10.1016/j.jtcvs.2011.03.034.
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