心脏创伤急诊的特殊性及外科策略

目的　探讨心脏创伤急诊分型及诊断的特殊性、伤因谱变化 ,总结对心脏创伤急诊的外科策略。　方法　回顾性分析 61例心脏创伤急诊病例的临床资料 ,分为 1 990年前后两组 ,比较两组病例数、伤因谱、创伤分型构成及住院死亡率等 ,并进行统计学检验。　结果　 1 990年后心脏创伤急诊病例数较 1 990年前明显增加 ,住院死亡率明显下降 (P <0 .0 5 ) ;两组伤因谱及创伤分型构成有明显变化 ;心脏创伤是心脏介入治疗的潜在并发症之一 ,更具特殊性。　结论　近十年来心脏创伤急诊有明显增多趋势 ,对心脏创伤急诊的分型应有新的认识 ;正确合理的分型有利于临床采取相关的外科策略 ,有效地提高救治成功率

Specialty in and surgical strategy for emergency treatment of cardiac trauma

Objective To explore the specialty of the classification and diagnosis of emergency treatment of cardiac trauma as well as trauma causes and summarize corresponding surgical strategy. Methods Clinical data of 61 cases with cardiac trauma were divided into two groups and analyzed retrospectively. Group A was those before 1990 and Group B after 1990. Cases, causes, trauma classification and mortality were compared between two groups and processed statistically. Results Compared with the Group A, the emergency cases were significantly increased in the Group B with significant decrease of mortality ( P <0.05). There were apparent changes in trauma causes and classifications in both groups. Cardiac trauma was special because it was one of latent complications during cardiac interventional treatment. Conclusions The cardiac trauma is likely to increase significantly in recent decade, and we must take a new look at emergency treatment classification of cardiac trauma. Reasonable classification is beneficial to clinical application of surgical strategy and can elevate the success rate in treating cardiac trauma.