摘要
目的 探讨大量心包积液和心脏压塞的诊断和治疗经验。方法 回顾性分析 1998年 1月至 2003年 1月我科收治的 36例心包积液致心脏压塞患者的临床资料,其中男性 25例,女性 11例,均由彩色超声心动图证实有心包积液及心脏压塞, 15例采用剑突下心包开窗、放置引流管, 21例采用经皮穿刺置管引流的方法。如病因不明,引流液尚需作进一步检查。结果 经引流 15min^2h后患者心脏压塞症状立即改善,早期 34例生存, 2例死亡病例分别因低心排出量和急性肝、肾功能衰竭于引流术后第 2、7d死亡。结论 早期准确诊断、彩色超声心动图指导下及时引流解除心脏压塞,可减轻症状并为进一步治疗提供保障。
Objective To review the experience of diagnosis and management of cardiac tamponade and pericardial effusion. Methods Thirty-six patients with cardiac tamponade were treated from Jan. 1998 to Jan. 2003 in our department. They were male in 25 and female in 11. The diagnosis was confirmed in all patients by echocardiography. Pericardiocentesis was preformed in 21 cases and subxiphoid surgical pericardiectomy was preformed in 15 cases. If the cause of the pericardial effusion is uncertain, 100 to 200 ml of fluid was collected for diagnostic studies, including cell count and differentiation, protein, lactate dehydrogenase, glucose, gram stain, and bacterial cultures, fungal cultures, myocobacterial acid fast stain, and culture. ResultsSymptoms of cardiac tamponade and pericardial effusion were relieved after pericardiocentesis or subxiphoid surgical pericardectomy in all patients. Thirty-four patients survived, 1 patient died of acute hepatic and renal failure and 1 patient died of low cardiac output with a mortality of 5.5% (2/36). Conclusion Identify early cardiac tamponade and intervene appropriately are very important. Along with a complete physical assessment, echocardiography remains the fastest and most accurate way to diagnose cardiac tamponade. Pericardiocentesis and subxiphoid surgical pericardiectomy are simple, safe, and effective for primary treatment of cardiac tamponade and pericardial effusion.
出处
《中华心律失常学杂志》
2005年第1期34-36,共3页
Chinese Journal of Cardiac Arrhythmias
