摘要
胸部外伤继发的心肌梗死比较罕见,文献报道的相关病例屈指可数。当心电图上的ST段抬高与心肌标志物阳性时,是外伤所致的心肌挫伤还是外伤导致的心肌梗死很难鉴别。本文报道1例高空坠落,被高空着地后反弹的钢板打中胸部,导致多发伤的患者,并讨论创伤导致的心肌梗死与创伤性心肌挫伤之间的异同,强调在评估胸部钝性损伤时须考虑冠状动脉病变可能性;探讨在胸部外伤情况下出现心肌梗死时,血栓与出血风险之间如何获得较好的平衡,并强调多学科协同的重要性,以使这类患者获得更好的治疗和护理。
Myocardial infarction secondary to chest trauma is rare,and few cases have been reported in the literature.When both ST segment and myocardial biomarkers are positive,it is difficult to distinguish whether it is a trauma-induced myocardial contusion or a trauma-induced myocardial infarction.We report a case of multiple trauma patient caused by falling and chest hitting with a steel plate rebounding after landing.To discuss the similarities and differences between traumatic myocardial infarction and traumatic myocardial contusion,possibility of coronary artery disease must be considered when evaluating blunt chest injury.To explore how to achieve balance between thrombosis and hemorrhage risk when myocardial infarction occurs in case of chest trauma,multidisciplinary cooperation can deliver better treatment and care.
作者
郝怿隆
叶慧
白金霞
宋威
秦龙
张黔
万健
Hao Yilong;Ye Hui;Bai Jinxia;Song Wei;Qin Long;Zhang Qian;Wan Jian(Department of Intensive Care Unit,Shanghai Pudong New Area People's Hospital,Shanghai 201299,China;Department of Intensive Care Unit,Shanghai Seventh People's Hospital,Shanghai 200137,China)
出处
《中华重症医学电子杂志》
CSCD
2023年第3期311-315,共5页
Chinese Journal Of Critical Care & Intensive Care Medicine(Electronic Edition)
基金
上海市浦东新区临床医学高原学科建设项目(PWYgy2021-09)
关键词
心肌梗死
心脏挫伤
多发伤
胸部钝性伤
Myocardial infarction
Cardiac contusion
Multiple injuries
Blunt chest trauma
作者简介
通信作者:万健,Email:drjian@yeah.net
