Trinkle J K, Toon R S, Franz J L, Arom K V, Grover F L
J Trauma. 1979 Jun;19(6):467-72. doi: 10.1097/00005373-197906000-00009.
During the 10-year period ending 1 March 1978, 100 consecutive patients with penetrating cardiac wounds entered the Bexar County Hospital with some sign of life. The early and late mortality rate, 11%, declined to 8% during the last 4 years. Noncardiac injuries were responsible for six of the eleven deaths. Complications occurred in 17. The most frequently injured chambers were the right ventricle (46) and left ventricle (30). Sixty-nine patients had stab wounds and 26 had gunshot wounds. Pericardiocentesis was falsely positive or negative in 12 of 47 patients. Two distinct syndromes were apparent, hemorrhagic shock and cardiac tamponade. Patients with shock had immediate thoracotomy. Patients with suspected tamponade had a subxiphoid pericardial window, under local or light general anesthesia, for diagnosis and decompression before endotracheal intubation and sternotomy. Most wounds were repaired by direct suture. Cardiopulmonary bypass and thoracotomy before arrival in the operating room were rarely indicated.
在截至1978年3月1日的10年期间，100例有生命体征的穿透性心脏创伤患者连续入住贝克斯县医院。早期和晚期死亡率为11%，在过去4年中降至8%。11例死亡中有6例是由非心脏损伤导致 的。17例出现并发症。最常受伤的心室是右心室（46例）和左心室（30例）。69例患者为刺伤，26例为枪伤。47例患者中有12例心包穿刺结果为假阳性或假阴性。出现了两种不同的综合征，即失血性休克和心脏压塞。休克患者立即进行开胸手术。疑似心脏压塞的患者在局部或轻度全身麻醉下，于气管插管和胸骨切开术前，通过剑突下心包开窗术进行诊断和减压。大多数伤口通过直接缝合修复。很少需要在到达手术室之前进行体外循环和开胸手术。
