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心脏穿通伤是严重的致命性损伤,常引起心包积血,合并胸腔损伤,导致心功能障碍及出血性休克,是战伤中重要的死因之一。本文报告4例生前未能确定死因,经尸检证实为心脏穿通伤死亡,特此报道如下。 1 病例报告 例1,女,45岁。主因心慌气短、咳嗽、全身浮肿8个月,近10天加重,于1961年10月11日入院。2个月前曾因结核性心包炎住院治疗,此次加重,再次入院。查体:T36℃,P100次/分,R27次/分,BP18.7/16kPa。急性病容,端坐呼吸,心界向两侧扩大,心音弱,未闻杂音,两肺(-),腹水征(+),肝在肋下4cm,两下肢浮肿。入院后进行X线检查,符合心包积液,第5天行心包穿刺,抽出浅红色
Cardiac penetrating injury is a serious fatal injury, often causing pericardial hemorrhage, chest injury combined, leading to cardiac dysfunction and hemorrhagic shock, is one of the important causes of war injuries. This article reports 4 cases failed to determine the cause of death during his lifetime confirmed by autopsy death of cardiac traumatic injury, are hereby reported below. 1 case report 1, female, 45 years old. Mainly because of palpitation shortness of breath, cough, body edema for 8 months, nearly 10 days aggravated, in October 11, 1961 admitted. 2 months ago was hospitalized for tuberculous pericarditis, the increase, re-admission. Physical examination: T36 ℃, P100 beats / min, R27 beats / min, BP18.7 / 16kPa. Acute illness, sitting and breathing, the heart bound to both sides of the expansion, weak heart sounds, no unheard noise, lung (-), ascites (+), liver in the ribs 4cm, lower extremity edema. X-ray examination after admission, in line with pericardial effusion, paracentesis on the 5th day, remove the light red