心脏大血管损伤2014ppt课件.pptVIP

心脏大血管损伤Cardiac and Great vessels’ Injury北京大学第一医院心外科杨 阳2013.12;分类：;Penetrating Cardiac Injuries;Penetrating Cardiac Injuries;Non Penetrating Cardiac Injuries;Non Penetrating Cardiac Injuries;;Non Penetrating Cardiac Injuries;心脏挫伤cardiac contusion;;心脏挫伤cardiac contusion;ECG 可正常 ST-T改变，ST段抬高，T波高尖、低平或倒置 心律失常：多种非特异性改变;;;心脏挫伤cardiac contusion;心脏挫伤cardiac contusion;心脏挫伤cardiac contusion;心脏挫伤cardiac contusion;心脏挫伤和心肌梗塞的鉴别;心脏破裂cardiac rupture;心脏破裂cardiac rupture; 心包内液体超过一定容量后，压力会随之上升。 压力上升幅度取决于心包内液体容量及容量增加的速度。 ;心脏破裂cardiac rupture;心脏破裂cardiac rupture;心脏破裂cardiac rupture;;;;;;;心脏破裂cardiac rupture;心脏破裂cardiac rupture;心包压???与失血性休克的鉴别;室间隔穿孔penetration of ventricular septum;;室间隔穿孔penetration of ventricular septum;瓣膜、腱索或乳头肌损伤injury to cardiac valves，chord or papillary muscles;;医源性心脏大血管损伤iatrogenic cardiovascular injury;iatrogenic cardiovascular injury;iatrogenic cardiovascular injury;iatrogenic cardiovascular injury;临床经验综述;Clinical feature 1. Trauma with critical situation, progress rapidly, high mortality. 2. Major symptom: chest pain, palpitation and dyspnea, etc. 3. Clincal sign: pericardial temponade, circulative shock .;The most valuable exam 1. Echocardiogram 2. CT scan 3. Angiocardiography;Therapy principle 1. First aid emergency treatment can decrease mortality. 2. Pericardiocentesis plays two roles: diagnose and relieve pericardial temponade 3. Close monitor and anti-shock therapy are required 4. Rapidly clarify diagnosis increase survival rate 5. Surgery as early as possible if necessary 6. Prevent complication