61例心脏刀刺伤的诊治体会

目的:探讨心脏刀刺伤的救治经验。方法:对1995年1月~2004年12月所收治的61例心脏刀伤病例的临床资料进行回顾性分析,用生理指数(PI)、胸部穿透伤指数(PTTI)、心脏穿透伤指数(PCTI)进行创伤评分,比较死亡组与生存组评分的差异,以及院前时间对死亡率的影响。结果:61例死亡5例,痊愈56例,创伤评分在生存者与死亡者之间差异有显著意义,P<0.05,评分相同病员院前时间越长,死亡率越高,分组中PI越高死亡率越高,P<0.05。结论:心脏刀刺伤救治成功的关键在于缩短院前时间及紧急剖胸手术。明确诊断的最佳方法是扩创探查,而建立一套与PI评分相适应的救治模式更能提高救治成功率。

Diagnosis and Treatment of 61 cases of Cardiac Trauma

Objective:To explore the experience of critical cure and treatment of cardiac trauma.Methods:61 cases patients with cardiac trauma were analyzed retrospectively.Traumatic scores were carried out by use of PI,PTTI and PCTI.The difference betwen dead group and living group in scores and the influence of duratiom before hospital to death rate were analysed.Results: In 61 cases,5 patients died and 56 patients survived.There was significant difference between the dead amd survived(P<0.05).The longer the time before hospital and the higher in PI,the higher in death rate(P<0.05).Conclusion: The Keys to successfully curing the cardiac trauma is shortening the time before hospital and critically undertaking the thoracotomy.The best methods of diagnosing clearly is enlarging trauma and inspecting.Establishing a treatment model agree with PI scores can promote the success rate.