剑突下心包开窗术治疗大量心包积液  

Subxiphoid Pericardial Window Drainage in the Management of Large Pericardial Effusions

作　　者：苗齐[1] 于洪泉[1] 任华[1] 王振捷[1] 沈文胜 

机构地区：[1]中国医学科学院,中国协和医科大学,协和医院,北京100730

出　　处：《中国医学科学院学报》1998年第3期216-219,共4页Acta Academiae Medicinae Sinicae

摘　　要：目的选择一种安全、有效、创伤小的方法,用于诊疗大量心包积液和心包填塞。方法回顾性分析本院心胸外科4年期间(1993年6月～1997年12月)收治的30例大量心包积液或心包填塞患者诊疗过程。所有患者均在心脏彩色超声确诊后,施行经剑突下心包开窗引流术、心包活检术。结果引流后患者症状立即改善,83%的患者可平卧或下床活动。术中心包积液引流量为200～2 000 ml,术后引流量0～2 000 ml,引流时间2～30 d,平均拔管时间为5.6 d。拔管后96.7%的患者术后超声证实,积液消失或仅有极少量心包积液。术后发生各种并发症6例,手术晚期死亡2例。根据术后病理诊断所有患者均得到确切诊疗。结论剑突下心包开窗术是一种简便、安全、有效的治疗大量心包积液或心包填塞的首选方法。Objective To choose a safe, effective, minimum invasive procedure for treatment of patients with a large pericardial effusion and cardiac tamponade. Methods Retrospective analysis of 30 cases with large pericardial effusion or cardiac tamponade diagnosed by echocardiography during four years (1993 ～ 1997). The subxiphoid pericardial window drainage and pericardial tissue biopsy was performed. Results The symptoms were improved immediately following the drainage. The drainage volume during operation was 200～2000 ml, and postoperation was 0～2000 ml. The drainage tube was kept in position for average of 5.6 days. With the echocardiography follow up, the pericardial effusion disappeared or remained only minimum fluid in 96.7% of the patients. The complications happened in 6 cases. The 30-days mortality was 6.7%. Conclusions The subxiphoid pericardial window drainage procedure is the first choice for a safe, effective, minimal invasive and easy to do procedure for the patients with a large pericardial effusions or cardiac tamponade.

关 键 词：心包积液 心包填塞 剑突下 心包开窗术 

分 类 号：R654.205[医药卫生—外科学]