دوشنبه 1 آبان 1396
به پورتال جامع کنگره ها - سمینارها و همایشهای دانشگاه علوم پزشکی تبریز خوش آمدید
   October 23, 2017
   
   
     
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عنوان Penetrating cardiac injuries in some centers like aliabadkatol
نویسندگان dr.roghaye ahmadi
چکیده Introduction Repair of cardiac wounds was considered impossible little over 100 years ago. Despite progress, penetrating cardiac injury remains a highly lethal form of trauma today. Cardiac tamponade and exsanguination are the greatest immediate and life-threatening risks. Clinical presentation is extremely variable and diagnosis may be highly deceptive. Unlike other forms of trauma, resuscitation is of limited value and urgent operative intervention is the only meaningful treatment. Refinements in cardiothoracic surgery and the simultaneous evolution of trauma care systems have both contributed to saving lives. It is understood that penetrating cardiac trauma is a highly lethal injury and those surviving to hospital have an overall mortality approaching 80%. Reported mortality figures vary widely and are extremely dependent on mechanism of wounding, cardiac chambers involved and possibly the presence of cardiac tamponade. Despite significant advances in prehospital care, operative techniques, and intensive care management, the mortality has not changed over several decades. This article will review 4 patients with cardiac injury, clinical presentation, and physical findings. you know that in this situation an expeditious evaluation with modalities available including, plain radiographs, sub-xiphoid window and echocardiography is needed but what should you do as a surgeon in some centers like Ali abad katol hospital suffering the lack of equipments. Back ground This study was planned to evaluate patients with penetrating cardiac injury in hospitals with or without necessary modalities such as Ali abad katol hospital. design and method The goal of this paper is to discuss how to ameliorate the management of penetrating cardiac injuries in general surgery or emergency department. the algorithm for the initial assessment of penetrating injuries in cardiac box is known but this article presenting procedure treatment of 4 patients had penetrating cardiac box (Stab wounds) in two years(NOV,2014_August,2016) admitted in Ali abad katol (baghyatalla) hospital based on my own experience who were admitted with penetrating cardiac injury (Stab wounds) in cardiac box, that 3 patients undergoing emergency thoracotomy and the mortality rate was 1/4(1 CASE had unrecordable blood pressure and no life sign at admission) that emergency department thoracotomy was done. results and conclusions The presentation of penetrating thoracic trauma can vary widely, from stable patients with few complaints to hemodynamically unstable patients requiring immediate life-saving interventions. Even apparently stable patients with penetrating chest injuries can deteriorate precipitously and a focused evaluation must be rapidly performed to assess for life-threatening conditions. Penetrating cardiac injuries are highly lethal condition. Cardiac tamponade, right ventricle lacerations and associated extra-cardiac injuries are independent risk factors of death but Patients arriving unstable may benefit from aggressive resuscitative efforts depending on transport time, so for patients with penetrating injuries in cardiac box we can help more and more about these patients think.
لغات کلیدی Trauma- Cardiac trauma- Penetrating injuries- cardiac box- emergency thoracotomy
 
     
     
 
 
     
     
 
 
     
     
 

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