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題名 | Blunt Chest Trauma with Cardiac Ruptures in Eastern Taiwan=東部地區胸部鈍傷合併心臟破裂 |
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作者 | 趙盛豐; 張比嵩; | 書刊名 | 慈濟醫學 |
卷期 | 15:1 2003.02[民92.02] |
頁次 | 頁27-31 |
分類號 | 416.262 |
關鍵詞 | 胸部鈍傷; 心臟破裂; 東部地區; Blunt chest trauma; Traumatic cardiac rupture; Papillary muscle rupture; |
語文 | 英文(English) |
中文摘要 | 目的:胸部鈍傷合併心臟破裂並不多見但是都須要緊急處理。有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例心臟破製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左心房或兩者皆有,另1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例患者以急性肺水腫表現。4例患者接受開胸手術,5例患者接受胸骨鋸開修補心臟或瓣膜置換手術。結果:4例以大量血胸表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的有4例存活。另1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及早診斷接受手術,預後十分良好。 |
英文摘要 | Objective: blunt chest trauma with cardiac is uncommon. A prompt diagnosis and treatment of this condition can save lives. This report reviews the outcomes and treatment of nine patients in eastern Taiwan who presented with cardiac rupture caused by blunt trauma. Patients and Methods: From January 1996 to January 2001, nine patients with cardiac rupture were operated 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 rupture of the right atrium, left atrium, or both, and one with posteromedial papillary muscle rupture. Four patients received a throacotomy, and five received a sternotomy to repair the heart or replace the mitral valve. Results: Prolonged sock after surgery caused the caused the death of the four patients with massive hemothroax. Four of five patients survived the sternotomy. The fifth patient died because of a delaying diagnosis in the emergency room. Counclusions: Patients who present with massive hemothorax have a poor prognosis. Prompt diagnosis and treatment of patients with cardiac tamponade or traumatic mitral regurgitation complicated with pulmonary edema generally produces good results. |
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