男子坐副驾驶削苹果，一脚急刹车，水果刀直插左胸，多条动脉断裂！医生：这种外伤死亡率超80%

近日，山西一男子坐在副驾驶位削苹果，车辆行驶途中因前方突发状况紧急刹车，该男子手中的水果刀因惯性直插胸部，相关话题登上热搜。

A man in Shanxi province who suffered a penetrating cardiac injury after a fruit knife pierced his chest during a sudden brake has been successfully treated and discharged from intensive care following a multidisciplinary rescue at Linfen People's Hospital.

事发当日，患者乘坐车辆行驶途中，因前方突发状况紧急刹车，坐在副驾驶位正在削苹果的他，手中的水果刀因惯性直插胸部。120急救车迅速将其送至医院急诊科。

The patient was in the front passenger seat peeling an apple while the vehicle was in motion. When the driver slammed on the brakes to avoid a sudden hazard, the knife was driven into his chest by inertia. 

入院时，患者面色苍白、意识模糊，血压极低，情况万分危急。急诊科立即启动创伤急救绿色通道，完善床旁超声、胸部CT等检查，考虑“胸部开放性损伤，左侧胸腔积血，心包积血，失血性休克，心包少量积液”。

医院迅速组织多学科专家紧急会诊，决定立即进行急诊手术。

He arrived at the emergency department pale, with critically low blood pressure and impaired consciousness, prompting the hospital to assemble a multidisciplinary team for emergency surgery.

术中探查发现，水果刀刺破左胸壁前壁，创口长约1.5cm，胸腔血性积液约2000ml左右，左侧胸腔胸膜与前上纵隔及心包折返处有破裂口，探查后未发现胸腔内有明显出血点。

刀刺伤导致左侧乳内动脉和肋间动脉全部断裂，两根血管四个残端同时喷血，医生立即给予结扎止血。在麻醉科医生的调整下，生命体征得以稳定。

手术历时2小时，最终成功完成。术后患者转入重症监护室，经精心治疗和护理，生命体征平稳，现已康复。

Intraoperative exploration revealed a 1.5-cm laceration on the left anterior chest wall and about 2,000 ml of bloody fluid in the thoracic cavity. The knife had severed both the left internal mammary artery and an intercostal artery, with all four vessel stumps bleeding simultaneously. 

The operation lasted two hours, after which the patient was transferred to the intensive care unit and later moved to a general ward in stable condition.

心脏大血管外科主任王振东表示，心脏穿透性外伤是极其凶险的外科急症，死亡率高达80%以上，尤其是心室破裂，出血迅猛，往往来不及送医就已失去生命体征。

Wang Zhendong, director of the cardiac and great vessel surgery department, noted that penetrating cardiac trauma is an extremely dangerous surgical emergency with a mortality rate exceeding 80 percent, especially when a ventricle is ruptured, as rapid hemorrhage can prove fatal before the patient reaches the hospital. 

据悉，从接诊到手术仅用时40分钟，患者及家属的急救知识立即压迫止血，而心包填塞对右心室的压迫止血作用，为抢救生命赢得了宝贵时间。

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专家提醒

乘车时切勿手持尖锐物品，尤其是刀具、剪刀等，急刹车或碰撞时极易造成严重伤害。平时多学习各种急救的科普知识，掌握实施现场急救办法。

若不幸发生胸部穿透伤，切勿自行拔除异物，要学会紧急止血的各种方法，应立即拨打120，保持患者平卧位，尽快送往有救治能力的医院。

Experts advise against holding sharp objects such as knives or scissors while riding in a vehicle, as sudden braking or a collision can cause severe injury. They also urge the public to learn first-aid skills. 

In the event of a penetrating chest wound, do not remove the object, apply pressure to control bleeding, call 120 immediately, keep the patient lying flat, and transport them to a hospital capable of handling such injuries as quickly as possible.

来源：山西临汾市人民医院 南方都市报 湖北发布

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