论文部分内容阅读
目的:总结南京医科大学附属南京第一医院近十年心脏外科术后床边紧急开胸的原因、手术指征和预后,为临床救治此类危重患者提供参考。方法:对19例心脏术后床边紧急开胸患者的临床资料进行回顾性分析。结果:急性大出血3例,心包填塞9例,心搏骤停4例,心脏破裂2例,广泛渗血1例。以上所有病例均因病情紧急而采取床边紧急开胸处理,结果痊愈出院15例,遗留脑功能障碍1例,死亡3例。结论:心脏术后出血、心包填塞、心脏破裂、心搏骤停是床边紧急开胸的常见原因。如果处理及时,方法得当,就能降低并发症和死亡率。
OBJECTIVE: To summarize the reasons, surgical indications and prognosis of bedside emergency thoracotomy after cardiac surgery in Nanjing First Hospital affiliated to Nanjing Medical University in recent ten years and provide references for clinical treatment of such critically ill patients. Methods: A retrospective analysis was performed on the clinical data of 19 patients undergoing heart surgery with emergency thoracotomy. Results: 3 cases of acute hemorrhage, 9 cases of cardiac tamponade, 4 cases of cardiac arrest, 2 cases of cardiac rupture and 1 case of extensive oozing. All of the above cases were emergency bedside emergency thoracotomy, resulting in 15 patients discharged, left brain dysfunction in 1 case, 3 died. Conclusions: Postoperative cardiac bleeding, tamponade, cardiac rupture, and cardiac arrest are common causes of bedside emergency thoracotomy. If handled properly, the method is appropriate, can reduce complications and mortality.