慢性缩窄性心包炎的诊断及手术治疗  

Clinical experience in the diagnosis and treatment of chronic constrictive pericarditis

作　　者：李国志[1] 赖登祥[1] 谭益[1] 余鑫[1] 唐胜军[1] 唐烽[1] 张俭荣[1] 

机构地区：[1]重庆三峡中心医院胸心外科,404000

出　　处：《重庆医学》2008年第4期363-364,共2页Chongqing medicine

摘　　要：目的总结分析慢性缩窄性心包炎的诊断和治疗经验。方法回顾性分析1993年1月-2006年10月96例慢性缩窄性心包炎的临床资料，男62例，女34例，年龄5～74岁，平均34岁，术前心功能Ⅱ级8例，Ⅲ级70例，Ⅳ级18例。胸骨正中切口88例，左前外侧切8例，均在全麻下行部分心包剥脱术。结果围术期死亡2例，其中术后低心排血综合征1例，术中右心房破裂出血修补失败1例，96例中有92例获得随访，心功能恢复到Ⅰ级者86例，恢复到Ⅱ级者6例。结论心包剥脱术仍是治疗此病惟一有效的方法，早期诊断、及时手术、充分合理的心包剥脱范围，正确的围术期处理是手术成功和提高远期疗效的关键。Objective To summarize the clinical experience in the diagnosis,treatment and outcome of chronic constrictive pericarditis. Methods From Jan 1993 to Dec 2006, the clinical data of 96 cases consecutive patients with chronic constrictive pericarditis were retrospectively reviewed. 62 male and 34 female,with a mean age of 34 years（range5to 74）. The cardiac function were 8 to class Ⅱ（NYHA）,70 to class Ⅲ,and 18 to class Ⅳ,88 patients applied median sternotomy and 15 patients applied left intercostal space thoracotomy,all patients under general anaesthesia. Results Two patients died postoperatively,1 cases was vital bleeding due to rupture of the right atrium, and the other was severe low cardiac out put syndrome, 92 of 96 cases were followed up. These patients had their cardiac function improved to NYHA class Ⅰ in 86 cases and class Ⅱ in 6 cases. Conclusion Pericardiectomy remains the only effective method for chronic constrictieve pericarditis. Early diagnosis,adequate preoperative preparation, the extent of pericardiectomy and appropriate management of postoperative complications are the key to ensure success of the operation and the satisfactory prognosis.

关 键 词：慢性缩窄性心包炎 心包剥脱术 诊断 治疗 

分 类 号：R654.2[医药卫生—外科学]