摘要：
目的 本研究旨在评估经胸超声心动图在心脏创伤中的应用价值.方法 回顾性分析15例心脏创伤患者的临床资料和超声心动图影像资料,超声诊断与手术结果进行比较.结果 超声心动图检出心包积液13例,其中9例伴血凝块形成,右室侧壁穿孔1例,三尖瓣腱索断裂伴重度三尖瓣反流1例,二尖瓣腱索断裂伴后叶穿孔1例,室间隔穿孔2例,金属异物存留1例,主动脉右冠瓣脱垂1例,右冠窦-右室分流1例.超声心动图对瓣膜损伤、室间隔穿孔、心包积液及异物存留的诊断与手术结果完全符合.漏诊右室壁穿孔4例,右室挫伤2例,右房壁穿孔2例,升主动脉近端壁血肿1例.结论 超声心动图检查是诊断心脏创伤快捷、有效的方法,且能在床旁进行急诊检查,对诊断心脏创伤诊断具有重要临床价值,并指导临床治疗.%Objective To evaluate the value of transthoracic echocardiography in cardiac trauma.Methods The clinical data and echocardiographic imaging data of 15 patients with cardiac trauma were analyzed retrospectively.Echocardiography diagnosis and surgical results were compared subsequently.Results Pericardial effusion was found in 13 cases by echocardiography,9 of them were combined with the formation of blood clots.Meanwhile,1 case showed perforation of the right ventricular lateral wall,1 case demonstrated tricuspid chordae tendineae rupture with severe tricuspid regurgitation,1 case was reported to have rupture of mitral chordae tendineae combined with perforation of the posterior mitral valve,2 cases with perforation of ventricular septum,1 case with retained metal foreign body,1 case showing right coronary cusp prolapse,and 1 case revealing right coronary sinus to right ventricular shunt.Echocardiographic diagnosis of valvular injury,perforation of ventricular septum,pericardial effusion,and foreign body retention was consistent with the surgical results.In addition,missed diagnosis cases in the study included 6 cases of right ventricular wall perforation or contusion,2 cases of right atrial wall perforation,and 1 case of hematoma involving the proximal ascending aorta wall.Conclusions Echocardiography is a rapid and effective diagnostic method,which can be used in the diagnosis of traumatic cardiac injury and for emergency examination bedside.Echocardiography is of great clinical value in the diagnosis of cardiac trauma and can help to guide therapy.
