Arreola-Risa C, Rhee P, Boyle E M, Maier R V, Jurkovich G G, Foy H M
Department of Surgery, Harborview Medical Center, Seattle, Washington 98104, USA.
Am J Surg. 1995 May;169(5):553-6. doi: 10.1016/S0002-9610(99)80217-7.
The purpose of this study was to identify factors associated with unfavorable outcome following stab wounds to the heart in order to improve selection of patients who may benefit from aggressive resuscitative efforts.
Preoperative and operative variables were reviewed for all patients treated for cardiac stab wounds at a level I trauma center from 1987 to 1993 in an attempt to identify factors influencing survival.
Twenty-nine (53%) of the 55 patients who were resuscitated following stab wounds to the heart during the study period survived. Although profound hypotension (systolic blood pressure < 40 mm Hg), cardiopulmonary resuscitation, and emergency room thoracotomies were associated with poor outcome, none were uniformly predictive of death. Some patients survived with each of these characteristics.
We recommend that all patients suspected of having cardiac stab wounds be fully resuscitated and undergo thoracotomy, as significant survival can be achieved and death is not always the outcome.
本研究的目的是确定心脏刺伤后不良结局相关因素，以改善对可能从积极复苏努力中获益的患者的选择。
回顾了1987年至1993年在一级创伤中心接受心脏刺伤治疗的所有患者的术前和手术变量，试图确定影响生存的因素。
在研究期间，55例心脏刺伤后接受复苏的患者中有29例（53%）存活。虽然严重低血压（收缩压<40mmHg）、心肺复苏和急诊室开胸与不良结局相关，但无一能完全预测死亡。有些具有这些特征的患者存活了下来。
我们建议，所有怀疑有心脏刺伤的患者都应充分复苏并接受开胸手术，因为可以实现显著的生存率，死亡并非总是结局。
