目的总结外伤性心脏破裂的急救流程及手术治疗方法。 方法回顾性分析广元市第一人民医院2001年6月至2013年6月收治13例心脏破裂患者的临床资料，其中男11例、女2例，年龄20～45（32.0±10.5）岁；病程30 min至2 h，平均（45.0±9.6）min。立即行床旁B超检查，其中12例急诊在全身麻醉、气管内插管下行心脏修补术，同期处理合并脏器损伤。 结果1例术前死于腹腔大出血，1例死于术后弥漫性血管内凝血（DIC），术中发生恶性心律失常2例，术后发生慢性胸骨骨髓炎2例，痊愈出院11例。出院后1个月复查心脏彩色超声，发现4例少量心包积液，余未见异常。 结论对于高度怀疑心脏破裂患者，建立快速的救治通道，早期准确诊断、及时手术治疗，是挽救患者生命的关键。
Objective To explore the feasibility of modified Bentall operation with pericardium lining in patients with aortic root dilatation (ARD). MethodsThis study was a retrospective study. From January 2023 to February 2024, the patients were selected for treatment in Suzhou Municipal Hospital, The Affiliated Traditional Chinese Medicine Hospital of Southwest Medical University and Guangyuan First People's Hospital. The preoperative clinical and imaging evaluation data (including echocardiography and CT of aortic root and whole aorta), the data of coronary intervention, the surgical effect and the postoperative follow-up results were collected. All patients were treated with improved Bentall operation with "pericardium lining": the aortic valve was replaced, and the autologous pericardium was divided into three parts according to the circumferential diameter of the aortic valve ring measured by the valve measuring instrument, and sutured with to the valve ring respectively; two pericardial slices "opened the window" and anastomosed anastomosis with the left and right coronary artery openings; the pericardial piece was sutured with to the aortic sinus wall to form a whole, narrowing the sinus. Artificial blood vessels were used to suture the proximal and distal aorta without aortic root-right atrial shunt. Results Five patients were collected, aged from 37 to 68 years. The average STS risk score was 3.4%. The preoperative ascending aorta diameter was (56.4±16.6) mm, the preoperative left ventricular end diastolic diameter was (62.0±9.0) mm, and the preoperative left ventricular ejection fraction was (56.0±8.0%. The time of aortic occlusion was (129.6±50.4) min, and the time of cardiopulmonary bypass was (188.2±113.8) min. Echocardiography showed that the diameter of ascending the ascending aorta was (30.2±4.8) mm, the end diastolic diameter of left the left ventricle was (48.2±8.8) mm, and the left ventricular ejection fraction was 51.4%±9.6%. The operation was successfully completed, and the immediate effect was satisfactory. There were no complications during the operation. There was no death and reoperation no reoperation during the follow-up period. Conclusion For patients with ARD, the preliminary results of improved Bentall operation with "pericardium lining" are satisfactory and the technique is feasible.