外伤性心脏破裂抢救6例体会

目的：回顾分析我院外伤性心脏破裂抢救的临床资料,明确外伤性心脏破裂手术抢救的入路与方法,以提高患者的存活率。方法：2005年6月~2010年4月我院完成6例外伤性心脏破裂的心脏修补术。所有患者均采用静脉多巴胺、肾上腺素维护血压,补充血容量,胸骨正中切口行心脏破裂修补术。结果：全组死亡1例,为左心室刀刺伤,积血破入左侧胸腔,因大出血休克死亡;其余5例病人均行心脏破口直视缝合,治愈出院。结论：外伤性心脏破裂,伤情重、发展快、应尽早做出诊断,及时果断进行抢救和急诊手术,入路与方法的选择不仅可以有效处理心脏破裂损伤,而且可以极大地提高患者的存活率。

The Surgical Experience of six cases That the Emergent Treatment for the Cardiac Rupture

Objective：Based on the analysis of clinical operations data and the experience of the 6 cases that the cardiac rupture in the last five years to make sure the methods and the approach of the operation and prolong the patients life.Methods： Between June 2005 and April 2010,6 cases（male 5,female 1）which are underwent the emergent operation of cardiac rupture tof,the patients were aged from 16years to 42 years,and weighted from 45 to 70 kg.All patients were treated with dopamine,epinephrine to maintain the blood pressure and supplement the blood volume,total repair the cardiac rupture through the sternal median incision.Results： lpatient died for the shock whose left ventricular was wounded and a lot of bleed went into the left thoracic cavity;the other 5 patients were cured.through suturing the heart crevasse.Conclusions： The early diagnosis and emergency operation are important to the cardiac rupture for the disease development,was rapid,the proper approach and the fmethods can deal with cardiac rupture and greatly improve the patients survival.