創傷性OHCA存活出院無神經學後遺症：病例報告

Surviving Traumatic OHCA without Neurological Sequelae: A Case Report

彭康祐(Kang-Yu Peng) ； 孫佩君(Pei-Chun Sun) ； 鄧允武(Yun-Wu Deng)

《輔仁醫學期刊》 13卷2期 (2015/06) Pp. 111-116

https://doi.org/10.3966/181020932015061302007

摘要

創傷性到院前心臟停止通常預後不佳，本篇報告一位36歲男性因機車對撞而現場心臟停止，經高級救護技術員急救後現場恢復心律，但在急診室不久又再次心臟停止，超音波顯示心包膜積液，緊急開胸術發現左心房破裂並予修補，此外病人合併有左側股骨開放性骨折、左側膝蓋骨粉碎性骨折與右側髖臼骨折併脫臼，住院中皆以固定術治療，歷經35天住院病人少見的以無神經學後遺症存活出院，現場及時處置與合宜的醫院治療是病人有良好預後的因素。

關鍵字

心臟鈍傷破裂 ； 創傷 ； 到院前心臟停止 ； 無脈電氣活動

並列摘要

The prognosis when a patient undergoes traumatic out-of-hospital cardiac arrest is not good. Herein we reported a 36-year-old male who underwent traumatic out-of-hospital cardiac arrest after a motorcycle collision. At the scene this patient recovered circulation after cardiopulmonary resuscitation by an emergency medical technician. Unfortunately cardiac arrest reoccurred in emergency department later. The echo analysis revealed pericardial effusion. Left atrium rupture was noted during thoracotomy and repairs were carried out. In addition to the cardiac arrest, this patient had an open fracture of the left femur, a comminuted fracture of the left patellar and a right hip fracture-dislocation. All these fractures were treated by surgical fixation. After 35 days of hospital admission the patient was discharged uneventfully without any neurological sequelae. On time treatment at scene and good hospital care are believed to have contributed to the good prognosis of this patient.

並列關鍵字

blunt cardiac rupture ； trauma ； out-of-hospital cardiac arrest ； OHCA ； pulseless electrical activity ； PEA