在韩国,血流动力学稳定的多处刀伤(包括下肢)患者在手术探查过程中心脏骤停:病例报告。

Journal of Trauma and Injury Pub Date : 2024-06-01 Epub Date: 2024-06-14 DOI:10.20408/jti.2024.0025
Jung Rae Cho, Dae Sung Ma
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引用次数: 0

摘要

刺伤,尤其是那些影响身体多个区域的刺伤,给创伤护理带来了相当大的挑战。本报告描述了一例 23 岁男性患者腹部和大腿持续性自伤刺伤的病例。虽然患者生命体征稳定,大腿伤口出血量极少,没有明显的血管损伤迹象,但患者右大腿突然大出血,导致心脏骤停。抢救成功后,对右侧股浅动脉损伤进行了手术修复,同时对主动脉进行了血管内球囊抢救。随后进行的下肢计算机断层扫描血管造影术未发现其他血管异常。术后第 12 天,患者病情稳定出院。本病例强调了刺伤轨迹的不可预测性以及潜在的隐性血管损伤,即使没有立即出现危及生命的体征。该病例还强调了计算机断层扫描血管造影术等先进成像模式在识别隐匿性损伤方面的关键作用,以及术中策略性技术(包括主动脉血管内球囊闭塞复苏术)在实现患者良好预后方面的重要性。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Experiencing cardiac arrest during surgical exploration in hemodynamically stable patients with multiple stab wounds, including lower extremity in Korea: a case report.

Stab wounds, particularly those affecting multiple body regions, present considerable challenges in trauma care. This report describes a case of sustained self-inflicted stab injuries to the abdomen and thighs of a 23-year-old male patient. Although the patient's vital signs were stable and bleeding was minimal from thigh wounds without overt signs of vascular injury, the patient experienced a sudden, profound hemorrhage from the right thigh, leading to cardiac arrest. Successful resuscitation was followed by surgical repair of a right superficial femoral arterial injury accompanying a resuscitative endovascular balloon of the aorta. Subsequent lower extremity computed tomography angiography revealed no additional vascular abnormalities. The patient was discharged in stable condition on the 12th postoperative day. This case underscores the unpredictability of stab wound trajectories and the potential for hidden vascular injuries, even in the absence of immediate life-threatening signs. It also emphasizes the critical role of advanced imaging modalities, such as computed tomography angiography, in identifying concealed injuries, and the importance of strategic intraoperative techniques, including resuscitative endovascular balloon occlusion of the aorta, in achieving favorable patient outcomes.

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