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[心脏骤停时石心综合征的预后意义]

[Prognostic implications of stone heart syndrome in cardiac arrest].

作者信息

Unseld J, Pflüger Patrick, Landeg Maximilian, Dommasch Michael, Kanz K-G, Bogner-Flatz V

机构信息

Klinik für Allgemeine, Unfall- und Wiederherstellungschirurgie, Klinikum der LMU München, München, Deutschland.

Klinik und Poliklinik für Unfallchirurgie, Klinikum rechts der Isar, Technische Universität München, München, Deutschland.

出版信息

Unfallchirurg. 2021 Mar;124(3):252-256. doi: 10.1007/s00113-020-00856-w.

Abstract

The stone heart syndrome is defined as an ischemic systolic contracture of the heart and also termed contractile cardiac arrest. It was first described in 1972 by the American cardiac surgeon Denton Cooley, who observed this phenomenon during bypass surgery. It is mostly the result of prolonged cardiac arrest where myocardial cells suffer hypoxia or anoxia. Insufficient forward blood flow and a decreased pressure gradient in the central aorta lead to reduced coronary perfusion. The resulting anaerobic metabolism causes an ischemic contracture as described in the stone heart syndrome. This article presents three cases of patients with traumatic cardiac arrest (TCA) and myocardial contracture in postmortem computed tomography (PMCT) and discuss the origins of the stone heart syndrome as well as its implications in cardiopulmonary resuscitation.

摘要

石心综合征被定义为心脏的缺血性收缩期挛缩,也被称为收缩性心脏骤停。它于1972年由美国心脏外科医生丹顿·库利首次描述,他在心脏搭桥手术中观察到了这种现象。它主要是长时间心脏骤停的结果,在此期间心肌细胞遭受缺氧或无氧状态。前向血流不足以及主动脉中心压力梯度降低导致冠状动脉灌注减少。由此产生的无氧代谢会导致如石心综合征中所描述的缺血性挛缩。本文介绍了三例创伤性心脏骤停(TCA)患者在死后计算机断层扫描(PMCT)中出现心肌挛缩的病例,并讨论了石心综合征的起源及其在心肺复苏中的意义。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3d1d/7921032/f8a78f568805/113_2020_856_Fig1_HTML.jpg

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