RESULTS OF RENDERING MEDICAL AID TO VICTIMS WITH PENETRATING HEART INJURIES AT THE GENERAL SURGERY DEPARTMENT

Journal Title: Novosti Khirurgii - Year 2018, Vol 26, Issue 4

Abstract

Objective. To analyze the results of providing aid to the victims with the heart injuries at the general surgery department. Methods. The retrospective analysis of the treatment results of 21 victims with penetrating injuries of the heart has been performed. There were 5 (23.8%) patients with stable hemodynamic parameters, 11 (52.4%) – with unstable parameters, 5 (23.8%) were delivered to the hospital in the preagony state. According to the criteria of American Association of Surgery Trauma (AAST), the class i of heart injury was diagnosed in 4 (19%) of the victims, iii – in 1 (4.8%), iv – in 5 (23.8%), V – 10 (47.6%), Vi – in 1 (4.8%) cases. According to the localization of cardiac trauma the left ventricle was most often damaged – in 10 (47.6%) cases, the left atrium – in 6 (28.6%) and the right ventricle – in 5 (23.8%) cases. Results. For the access to the heart in 20 patients, the anterolateral thoracotomy in the iv-V intercostal space was applied, only in one case, the bilateral thoracosternotomy («clamshell») was used. 7 (33%) patients died, the cause of death in 4 (19%) was the hemorrhagic shock due to massive blood loss, in 2 (9.5%) - cardiac tamponade, 1 (4.7%) patient died of acute myocardial infarction on the second day after the surgery. Overall postoperative mortality made up 33%. As the analysis demonstrates, the condition of the patient's hemodynamics determines a differentiated approach to the corresponding diagnostic algorithm. The main method of treatment of heart injuries is emergent thoracotomy, temporary bleeding stop with subsequent suturing the wound of the heart against the background of resuscitation measures. Conclusions. Survival rate of patients with heart injuries depends on the appropriate evacuation and medical measures at the prehospital stage, compliance with the organizational algorithm of providing medical care and qualification of medical personnel.

Authors and Affiliations

B. О. МАTVIYCHUK, YU. Y. HOLYK, Y. M. KNYSH, V. Т. BOCHAR, Т. М. FEDORYSHYN

Keywords

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  • EP ID EP572932
  • DOI 10.18484/2305-0047.2018.4.502
  • Views 71
  • Downloads 0

How To Cite

B. О. МАTVIYCHUK, YU. Y. HOLYK, Y. M. KNYSH, V. Т. BOCHAR, Т. М. FEDORYSHYN (2018). RESULTS OF RENDERING MEDICAL AID TO VICTIMS WITH PENETRATING HEART INJURIES AT THE GENERAL SURGERY DEPARTMENT. Novosti Khirurgii, 26(4), 502-508. https://europub.co.uk./articles/-A-572932