Zakharia A T
J Cardiovasc Surg (Torino). 1987 Jul-Aug;28(4):380-3.
This study evaluates factors influencing survival in 285 battle cardiac injuries, treated in Lebanon from 1969 to 1982. Survival factors included age (mean 18 years), transportation lag (mean distance 2 miles), wounding agents (shrapnel, gunshot), hospital logistics, and early surgical treatment. The overall survival was 73% (208 patients) compared to 60% from World War II and 67% from recent civilian report. Treatment logistics included a specialized centre with ambulance radio communication. The state of shock at arrival influenced survival: 146 of 188 patients with mild shock survived (78%) with 61% (53 patients) survival in the profound shock group, treated similarly. The site of cardiac injury influenced outcome. Survival was best in the 9 patients with coronary vessel wounds (100%), atrial wounds 80% (56 survivors) but dropped to 46% (17 survivors) in left ventricular injury reflecting pump failure, and 51% (19 survivors) in multiple cardiac wounds. The causes of cardiac mortality and survivor follow-up were evaluated. The study indicates that despite predetermined factors overall survival is significantly improved by early transportation, precise logistics, and urgent surgery.
本研究评估了1969年至1982年在黎巴嫩接受治疗的285例战伤心脏损伤患者的生存影响因素。生存因素包括年龄（平均18岁）、转运延迟（平均距离2英里）、致伤因素（弹片、枪伤）、医院后勤保障以及早期手术治疗。总体生存率为73%（208例患者），相比之下，第二次世界大战时为60%，近期 civilian 报告为67%。治疗后勤保障包括一个配备救护车无线电通信的专业中心。到达时的休克状态影响生存：188例轻度休克患者中有146例存活（78%），深度休克组经类似治疗后生存率为61%（53例患者）。心脏损伤部位影响预后。9例冠状动脉损伤患者的生存率最高（100%），心房损伤患者为80%（56例存活），但左心室损伤因泵衰竭生存率降至46%（17例存活），多处心脏损伤患者为51%（19例存活）。评估了心脏死亡原因及存活者随访情况。该研究表明，尽管存在预定因素，但早期转运、精确的后勤保障和紧急手术可显著提高总体生存率。
