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对于钝性心脏损伤患者进行心脏探查时,体外循环准备是必不可少的:两例病例报告。

Cardiopulmonary bypass preparation is mandatory in cardiac exploration for blunt cardiac injury patients: two case reports.

作者信息

Son Shin-Ah, Cho Joon Yong, Kim Gun-Jik, Lee Young Ok, Jung Hanna, Oh Tak-Hyuk

机构信息

Department of Thoracic and Cardiovascular Surgery, School of Medicine, Kyungpook National University, Kyungpook National University Hospital, Daegu, Korea.

出版信息

Yeungnam Univ J Med. 2021 Oct;38(4):356-360. doi: 10.12701/yujm.2020.00822. Epub 2021 Mar 3.

Abstract

Treating cardiac injuries following blunt trauma to the chest requires thorough examination, accurate diagnosis, and therapeutic plan. We present two cases; pulmonary vein rupture and left atrial appendage laceration, both as a result of blunt chest trauma. Through these cases, our team learned the importance of maintaining hemodynamic stability during the examination of injured cardiac structures. And based on the comprehensive cardiac examination, a decision to surgically intervene with median sternotomy via cardiopulmonary bypass was made, saving lives of the patient. This report introduces how such decision was made based on what supporting evidence and the diagnostic process leading to the initiation of surgical intervention. This report may help with decision-making process when confronted by blunt cardiac injury patients who need cardiac exploration.

摘要

治疗胸部钝性创伤后的心脏损伤需要进行全面检查、准确诊断并制定治疗方案。我们呈现两例病例;一例是肺静脉破裂,另一例是左心耳撕裂,均由胸部钝性创伤所致。通过这些病例,我们团队认识到在检查受损心脏结构时维持血流动力学稳定的重要性。基于全面的心脏检查,我们决定通过体外循环进行正中开胸手术干预,从而挽救了患者生命。本报告介绍了基于何种支持证据做出这一决定以及导致启动手术干预的诊断过程。本报告可能有助于在面对需要心脏探查的钝性心脏损伤患者时的决策过程。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/cf74/8688786/fbb25ffe1bf6/yujm-2020-00822f1.jpg

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