体外循环在心脏及大血管损伤急救中的应用

目的临床评价体外循环（CPB）在心脏及大血管损伤急救中的应用和疗效。方法从2003年7月至2010年12月我院急诊应用CPB技术救治创伤所致心脏及大血管破裂患者11例。其中3例为创伤所致心脏穿透伤,3例为创伤所致颈部大血管损伤,4例为肾癌根治术中下腔静脉破裂,1例为肺叶切除术中肺静脉破裂。结果全组死亡1例（9.1%）,为颈部刀刺伤及无名动脉,术前已经出现失血性休克和心跳骤停;其余患者均顺利康复出院。结论准确的判断,及时有效的术前处理,尽早建立CPB,加强CPB管理,可有效提高创伤所致心脏及大血管破裂的救治成功率。

Application of cardiopulmonary bypass in emergency treatment for cardiac injury and cardio great vessel trauma

Objective To evaluate the efficacy of cardiopulmonary bypass（CPB） in emergency treatment for cardiac injury and cardio great vessel trauma.Methods A total of 11 cases of cardiac injury and cardio great vessel trauma were treated emergently by cardiopulmonary bypass from July 2003 to December 2010 in our center,including 3 cases of cardiac rupture,3 cases of cervical vascular injury,4 cases of inferior vena cava rupture during radical nephrectomy and 1 case of pulmonary vein rupture during pulmonary lobectomy.Results one case which experienced hemorrhagic shock and cardiac arrest preoperatively died（9.1%） due to innominate artery rupture.The rest cases were recovered and discharged.Conclusion Correct judgement,effective preoperative emergency treatment,establishing CPB as early as possible and enhancing CPB administration can improve the survival rate for patients with cardiac injury and cardio great vessel trauma.