- 期刊
Blunt Chest Trauma with Cardiac Ruptures in Eastern Taiwan
東部地區胸部鈍傷合併心臟破裂
摘要
目的:胸部鈍傷合併心臟破裂並不多見但是都需要緊急處理。本文報告東部地區胸部鈍傷合併心臟破裂的手術結果。病人與方法:自民國85年1月到90年1月，共有9例心臟破裂的患者在慈濟醫院接受心臟手術治療。8例患者合併有其他傷害，8例患者心臟破裂的位置分別在右心房或在左心房或兩者皆有，另一例為左心室後內側乳突肌斷裂。4例患者以大量血胸表現，4例患者以心包填塞表現，1例患者以急性肺水種表現。4例患者接受開胸手術，5例患者接受胸骨鋸開修補心臟瓣膜置換手術。結果:4例以大量血胸表現的患者在術後皆死於術前長時間休克。5例接受胸骨鋸開手術的患者中有4例存活。另一例患者因為在急診延誤診斷術後死亡。結論:胸部鈍傷合併心臟破裂如果以大量血胸表現，預後不佳， 如果以心包填塞或肺水腫表現並且能夠及早診斷接受手術，預後十分良好。(慈濟醫學 2003; 15:27-31)
並列摘要
Objective: Blunt chest trauma with cardiac rupture is uncommon. A prompt diagnosis and treatment of this condition can save lives. This report reviews the outcomes and treatment of nine patients in eatern Taiwan who presented with cardiac rupture caused by blunt chest trauma. Patients and Methods: From January 1996 to January 2001, nine patients with cardiac rupture were oper-ated on at Tzu Chi General Hospital. Eight patients had associated injuries. Three patients presented with undetectable blood pressure, four with massive hemothorax, four with cardiac tamponade, one with acute pulmonary edema, eight with cardiac ruptures of the right atrium, left atrium, left atrium, or both, and one with posteromedial papillary muscle rupture. Four patients received a thoracotomy, and five received a sternotomy to repair the heart or repair the heart or replac the mitral vale. Results: Prolonged shock after surgery caused the deah of the four patients with massive hemothorax. Four of five patients survived the strnotomy. The fifth patient died because of a delayed diagnosis in the emergency room. Conclusions: Patients who present with massive hemothorax have a poor prognsis. Prompt diagnosis and treatment of patients with cardiac tamponade or traumatic mitral regurgitation complicated with pulmonary edema generally produces goood results.(Tzu Chi Med J 2003; 15:27-31)