Abstract：Objective To analyze the pathophysiological variation in patients with penetrating cardiac trauma (PCT) and discuss the classified treatment strategies. Methods A retrospective analysis was conducted on pathogenetic condition, medical interventions and other clinical information of 133 PCT patients. The patients were divided into four groups in accordance with their symptom classification on arrival at emergency department, including sub-clinic type, cardiac tamponade type, hemorrhagic shock type and agonal type. Meanwhile, the patients were classified into three groups according to their pathogenesis phase, including sub-clinical phase, clinical phase and agonal phase. Development characteristic of patients’ condition in each group was investigated in each time point by survival analysis. Impacts of medical interventions on prognosis of those patients were analyzed, such as pericardial space exploration, emergency room thoracotomy （ERT）, operating room thoracotomy (ORT). Results Some patients at sub-clinical phase were aggravated into clinical phase or agonal phase, as well as some patients at clinical phase were aggravated into agonal phase during in-hospital treatment. There were significance differences of posttraumatic survival course among the four groups, namely sub-clinical type, cardiac tamponade type, hemorrhagic shock type and agonal type （P＜0.01）. The differences of posttraumatic survival course were also significant among the three groups, namely sub-clinical phase, clinical phase and agonal phase （P＜0.01）. Conclusion Clinical symptom classification (or pathogenesis phase) of PCT may not be always unchangeable, thus it is recommended that PCT patients should be treated based on their clinical symptom classification or pathogenesis phase at consultation.
YANG Bo,YANG Jian. Injury evolution and classified treatment in survival process of penetrating cardiac trauma[J]. CHINESE JOURNAL OF TRAUMA, 2013, 29(3): 201-206.
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