Pillet J C, Mondine P, Bezon E, Baccino E, Thomas E, Braesco J, Egreteau P, Barra J A
Service de Chirurgie Cardio-Thoracique et Vasculaire, CHU de Morvan, Brest.
J Chir (Paris). 1995 Mar;132(3):123-6.
Stab wounds of the heart are frequent: one case every two and a half months in our service. In our series of 9 cases, only three were alive at arrival to the emergency ward, but in all of these three, treatment was simple requiring only simple wound suture without extra-corporeal circulation. Based on our experience and the data in the literature, we propose cooperation between three teams for managing these patients: anaesthesists, echocardiographists and cardiothoracic surgeons. The patients are admitted directly to the cardiothoracic operating theatre where the echocardiographist and the surgery team take charge. The surgical procedure depends on the general situation and especially on whether or not the echocardiologist can confirm haemopericardium immediately. Every patient with possible wound to the heart or major vessels should be managed directly by the cardiothoracic surgery team before of formal diagnosis has been established.
在我们科室每两个半月就有一例。在我们的9例病例系列中，只有3例在到达急诊病房时还活着，但在这3例中，治疗都很简单，只需要简单的伤口缝合，无需体外循环。根据我们的经验和文献数据，我们建议由三个团队合作来管理这些患者：麻醉师、超声心动图专家和心胸外科医生。患者直接被送往心胸外科手术室，由超声心动图专家和手术团队负责。手术程序取决于患者的一般情况，特别是超声心动图专家能否立即确认心包积血。在正式诊断确立之前，每一位可能有心脏或大血管损伤的患者都应由心胸外科团队直接处理。
