Demetriades D
Br J Surg. 1984 Feb;71(2):95-7. doi: 10.1002/bjs.1800710205.
This study represents the personal experience of the author, in 45 cases of penetrating cardiac wounds. Eleven patients with no signs of life had surgical intervention on the stretcher in the emergency room (ER). One patient survived (mortality 91 per cent). Thirty-four patients were operated on in the operating theatre (OT) with a mortality rate of 12 per cent. The clinical triad of a low blood pressure, high central venous pressure (CVP) and distant cardiac sounds, proved diagnostic in 82 per cent of the patients with cardiac tamponade. Pulsus paradoxus was found in only 7 per cent of tamponade cases. Pericardiocentesis seems to have little value in diagnosing or treating tamponade. The most commonly injured cardiac chamber was the right ventricle (RV) (36 per cent). Coronary artery damage occurred in 4 cases with a mortality of 75 per cent. Aspiration of the ventricles for air embolism was performed in all 16 cases who arrested during operation. A significant volume of air was aspirated in 4 (25 per cent). Early intervention saved three of them.
本研究展现了作者对45例穿透性心脏创伤的个人经验。11例无生命体征的患者在急诊室（ER）的担架上接受了手术干预。1例患者存活（死亡率91%）。34例患者在手术室（OT）接受手术，死亡率为12%。低血压、高中心静脉压（CVP）和心音遥远这一临床三联征在82%的心脏压塞患者中具有诊断价值。仅7%的压塞病例发现有奇脉。心包穿刺术在诊断或治疗压塞方面似乎价值不大。最常受伤的心脏腔室是右心室（RV）（36%）。4例发生冠状动脉损伤，死亡率为75%。所有16例术中心脏停搏的患者均进行了心室空气栓塞抽吸。4例（25%）抽出了大量空气。早期干预挽救了其中3例患者。
