Kalp yaralanmalarında tanı yöntemleri ve tedavi
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Tarih
2016
Yazarlar
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Cilt Başlığı
Yayıncı
Erişim Hakkı
info:eu-repo/semantics/openAccess
Özet
Travma genç nüfus içindeki en önemli ölüm nedenlerindendir. Son yıllarda ilk yardım uygulamaları ve hızlı ulaşımda kaydedilen gelişmeler nedeniyle, acil servislere yetiştirilebilen penetre kalp yaralanmalı olgu sayısı giderek artmaktadır. Bu çalışmada penetre kalp yaralanması nedeniyle kliniğimizde cerrahi tedavi uygulanan olgular retrospektif olarak değerlendirilmiştir. 2000-2008 yılları arasında 98 penetre kardiyak yaralanma olgusu opere edilmiştir. Olguların 8’i kadın, 90’ı erkeklerden oluşmaktadır. Hastaların yaş aralığı 3-67 olup, yaş ortalaması 26.3±11.4 olarak bulunmuştur. Penetran kalp yaralanması nedeniyle opere edilen hastaların 84’ü kesici delici alet yaralanması, 11’i ateşli silah yaralanması, 3’ü ise iyatrojenik girişim sonucu oluşmuştur. Hemodinamik olarak stabil olan 15 olguya preoperatif echo kardiyografi ile tanı konulmuştur. Geriye kalan olgularda ise fizik muayeneden hemen sonra acil koşullarda opere edilmiştir. 90 olguya sol anterior torakotomi, 4 olguya sağ anterior torakotomi ve son olarak 4 olguya ise median sternotomi uygulanmıştır. 98 olguluk serimizin 16’sı mortalite ile sonuçlanmıştır. Postoperatif ekokardiyografi ile 2 olguda 2. ameliyatı gerektiren ventriküler septal defekt ve aortikopulmoner fistül tespit edilmiştir.
Trauma is a major cause of a death in young population. Penetrating trauma to the heart which delivered to the emergency rooms has been increasing in the last years, because of the improved first aid and rapid transport techniques. In this study, the results of surgically trated penetrating cardiac trauma at our department were evaluated retrospectively. Between 2000-2008, 98 cases of penetrating cardiac trauma were operated at our instution. The age range and the mean age were 3-67 and 26.3±11.4 respectively. There were only 8 female patients among the 98 ones. 84 cases of penetrating cardiac injury had stab wounds, 11 patients had gunshot wounds and remaining 3 patients had iyatrojenic effect. 15 patients who were stable hemodynamically diagnosed with preoperative transthoracic echocardiography, while remaining ones underwent operation urgenty soon after physical operation. Left anterior toracotomy was performed in 90 cases, right anterior toracotomy was also performed in 4 cases and remaining part of the cases has been operated by impliying median sternotomy. There were 16 operative mortality among the 98 patients. Postoperative echocardiography revealed ventricular septal defect and aorticopulmoner fistul in two patients, which required a second operation.
Trauma is a major cause of a death in young population. Penetrating trauma to the heart which delivered to the emergency rooms has been increasing in the last years, because of the improved first aid and rapid transport techniques. In this study, the results of surgically trated penetrating cardiac trauma at our department were evaluated retrospectively. Between 2000-2008, 98 cases of penetrating cardiac trauma were operated at our instution. The age range and the mean age were 3-67 and 26.3±11.4 respectively. There were only 8 female patients among the 98 ones. 84 cases of penetrating cardiac injury had stab wounds, 11 patients had gunshot wounds and remaining 3 patients had iyatrojenic effect. 15 patients who were stable hemodynamically diagnosed with preoperative transthoracic echocardiography, while remaining ones underwent operation urgenty soon after physical operation. Left anterior toracotomy was performed in 90 cases, right anterior toracotomy was also performed in 4 cases and remaining part of the cases has been operated by impliying median sternotomy. There were 16 operative mortality among the 98 patients. Postoperative echocardiography revealed ventricular septal defect and aorticopulmoner fistul in two patients, which required a second operation.
Açıklama
Anahtar Kelimeler
Kalp yaralanmaları, Heart injuries, Travma
