ĐÁNH GIÁ CHẨN ĐOÁN VÀ ĐIỀU TRỊ VẾT THƯƠNG TIM TẠI BỆNH VIỆN NHÂN DÂN 115 TRONG 10 NĂM (7/2004 -7/2014)

Abstract

Introduction: Cardiac wounds are surgical emergency, which is relatively uncommon. Their causes may be gunshot or stab wounds. The risk of death before admitted to hospital is high because of bleeding. Early diagnosis and timely surgical intervention will save lives.
Objectives: Evaluation of diagnosis and treatment of cardiac wound at Hospital 115 for 10 years (7/2004-7/2014).
Methods: Cross-sectional and retrospectiveclinical study. Cardiac wound patients have be described the epidemiological characteristics, identified the diagnostic process, treatment and evaluation the results of surgical treatment with successful surgical cases as well as complications or deaths. *
Results: For 10 years (7/2004 - 7/2014), at Hospital 115, 50 cases of patients with cardicac wounds were treament. The mean age 20 ± 3.3 with 96% of men. Causes of wounds are sharp objects. Most of wound locations on the chest are on the risk area. The syndrome of cardiac tamponade occur 72%, hemorrhagic shock 30%. Damage at right ventricle is 52% and left ventricle 30%). Treatment of suturing wounds had good result (78%), complications (8%) and mortality 14%.

Discussion and conclusion: At Hospital 115, every year has around 5 cardiac wound cases caused by sharp objects and happened in the daily activities. Most of patients were men and young. Diagnosis based on clinical examination and high efficiency technology as echocardiography, chest CT scan, pericardiocentesis. The general trend was to minimize diagnostic time and avoid of bleeding. The proportion of patients with cardiac tamponade was high. Surgical treatment was more effectively. Mortality 14% mainly due to severe injuries, combined injuries or the time from the accident to surgery was extended.