DeGennaro V A, Bonfils-Roberts E A, Ching N, Nealon T F
J Thorac Cardiovasc Surg. 1980 Jun;79(6):833-7.
Since 1970 all patients admitted with penetrating injuries near the cardiac silhouette are transferred immediately to the operating room for resuscitation and evaluation for immediate thoracotomy. The clinical courses of 10 patients with penetrating cardiac injuries treated between 1962 and 1969 were analyzed and compared with those of 33 patients who presented between 1970 and 1977 and were managed more aggressively. Since the institution of this more aggressive policy, overall survival has improved from 20% to 67%. In patients arriving in the emergency room with signs of viability, survival increased from 29% to 76%. Of 53 patients with injuries in the area of the cardiac silhouette, 33 (62%) actually sustained cardiac injury. The high probability of cardiac injury in patients with external wounds in the silhouette and the improved survival rate seen with aggressive surgical therapy justifies the change to this policy.
自1970年起，所有心脏轮廓附近有穿透伤的入院患者均立即被送往手术室进行复苏，并评估是否需要立即开胸手术。分析了1962年至1969年间接受治疗的10例穿透性心脏损伤患者的临床病程，并与1970年至1977年间就诊且治疗更为积极的33例患者进行了比较。自从实施这种更积极的治疗策略以来，总体生存率已从20%提高到了67%。在抵达急诊室时仍有存活迹象的患者中，生存率从29%提高到了76%。在53例心脏轮廓区域受伤的患者中，33例（62%）实际上发生了心脏损伤。对于心脏轮廓处有外部伤口的患者，心脏损伤的可能性很高，而积极的手术治疗提高了生存率，这证明了采用这一治疗策略的合理性。
