Cha E K, Mittal V, Allaben R D
Department of Surgery, Wayne State University, Grace Hospital, Detroit, Mich.
Arch Surg. 1993 Aug;128(8):836-9; discussion 839-41. doi: 10.1001/archsurg.1993.01420200010001.
We studied delayed or residual manifestations of penetrating cardiac injury in patients to determine the incidence, type, management, and outcome.
Penetrating cardiac injury is associated with a high mortality despite improvement in management in recent years. Secondary lesions that are usually not looked for at the time of initial surgery are diagnosed and repaired postoperatively.
Retrospective study.
The study was conducted at a major urban trauma center.
Forty-eight survivors of 71 penetrating cardiac injuries were treated during a 10-year period from 1980 to 1990.
Delayed sequelae were diagnosed in 11 patients (23%) during the postoperative period. There were five ventricular septal defects, two aortic valvular injuries, one atrial septal defect, two conduction defects, and one tricuspid valvular lesion. All lesions were repaired electively with 100% survival.
We found residual or delayed sequelae in 23% of our patients. Close follow-up and utilization of diagnostic studies, including two-dimensional echocardiography during the early postoperative period, can identify late sequelae and allow elective repair.
我们研究了穿透性心脏损伤患者的延迟或残留表现，以确定其发生率、类型、治疗方法及预后。
尽管近年来治疗有所改善，但穿透性心脏损伤的死亡率仍然很高。初次手术时通常未被发现的继发性损伤在术后被诊断并修复。
回顾性研究。
该研究在一家大型城市创伤中心进行。
1980年至1990年的10年间，71例穿透性心脏损伤患者中有48例存活。
术后期间11例患者（23%）被诊断出延迟性后遗症。有5例室间隔缺损、2例主动脉瓣损伤、1例房间隔缺损、2例传导缺陷和1例三尖瓣病变。所有病变均择期修复，存活率为100%。
我们发现23%的患者有残留或延迟性后遗症。密切随访并利用诊断性检查，包括术后早期的二维超声心动图，可识别晚期后遗症并进行择期修复。
