Yamada S, Yamazaki M, Mori K, Kosaka A
Department of Surgery, Shimizu City Hospital, Shizuoka, Japan.
Jpn J Thorac Cardiovasc Surg. 1998 Oct;46(10):953-6. doi: 10.1007/BF03217853.
A 60-year-old Asian man who suffered penetrating thoracoabdominal injuries was admitted to our hospital in a state of shock. Because the results of a chest computed tomogram (CT) strongly suggested a left ventricular injury, an emergency thoracotomy was performed. A laceration of the left ventricle (3 cm) was sutured and was closed without cardiopulmonary bypass, and coexisting lacerations of the superior mesenteric artery (SMA) and small bowel were surgically repaired. During the procedure, cardiac arrest occurred, but the patient recovered without any apparent neurologic deficit. Postoperative examinations using echocardiogram, CT, and cardiac catheterization revealed a delayed rupture of the left ventricle. On the 28th day after surgery, he was transferred to another hospital for elective cardiac surgery. Primary management of penetrating cardiac injury is discussed in this report.
一名60岁的亚洲男性遭受穿透性胸腹伤，以休克状态被收入我院。由于胸部计算机断层扫描（CT）结果强烈提示左心室损伤，遂进行了急诊开胸手术。左心室一处3厘米的裂伤在未使用体外循环的情况下进行了缝合和闭合，同时对并存的肠系膜上动脉（SMA）和小肠裂伤进行了手术修复。手术过程中发生了心脏骤停，但患者恢复后未出现明显的神经功能缺损。术后通过超声心动图、CT和心导管检查发现左心室延迟破裂。术后第28天，他被转至另一家医院接受择期心脏手术。本报告讨论了穿透性心脏损伤的初步处理。
