心脏直视手术后迟发性心脏压塞的临床研究  

Clinical research of late cardiac tamponade following open heart surgery

作　　者：李建安[1] 严中亚[1] 

机构地区：[1]安徽省立医院心脏外科,合肥230001

出　　处：《安徽医学》2006年第6期443-445,共3页Anhui Medical Journal

摘　　要：目的总结心脏直视手术后迟发性心脏压塞（LCT）的诊治和预防经验。方法就2002年1月至2005年12月发生的7例LCT的原发疾病、引流时间和引流量、LCT时间、诊断和处理方法、引流液性质等资料进行总结分析。结果实施心包引流时间为术后21天-10个月，其中4例进行心包穿刺置管引流术，2例行左侧心包开窗术，1例行剑突下心包开窗置管引流术，5例痊愈出院，2例死于呼吸衰竭。结论心脏手术后LCT是发生率较低但后果严重的并发症，可能与术后抗凝治疗、右心功能不全、淋巴管损伤、心包切开综合征、急性心脏排斥反应和环孢霉素A的使用、术后心包纵隔引流不畅、心包腔残存空腔较大等有关。及时的诊断和心包腔引流是提高LCT治疗效果的关键。Objective To review the diagnosis, treatment and complications prevention of late cardiac tamponade （LCT） after open heart surgery. Methods Between Jan 2002 and Dee 2005,1050 patients underwent open heart surgery at the Anhui Provincial Hospital. In of 1050 7 patients （0.67%） developed cardiac tampenade. Their symptoms included fatigue, anorexia, abdominal distension or dyspnea etc. The diagnosis was made by eehocardiography in all patients. Results Echocardiography guiding pericardiocentesis was effective in decompressing tampenade in 4 of 7 patients. Two patients required operative surgical drainage. Two patients died of respiratory failure. Conclusion To enhance the result of LCT, diagnosing and draining in time is very important.

关 键 词：心脏直视手术 迟发性心脏压塞 

分 类 号：R654.2[医药卫生—外科学]