纤维心包镜在中大量心包积液病因诊断中的应用  

Application of pericardioscopy in the etiologic diagnosis of moderate or significant pericardial effusion

作　　者：王长厚[1] 牛和平[1] 万艳芳[1] 费玲[1] 刘静[1] 

机构地区：[1]河北医科大学附属沧州市中心医院心内科,沧州061001

出　　处：《中国心血管杂志》2009年第5期361-363,共3页Chinese Journal of Cardiovascular Medicine

摘　　要：目的观察纤维心包镜在中大量心包积液诊断中的作用。方法对188例中大量心包积液病因不明患者进行剑突下心包开窗术及纤维心包镜检查,明确心包积液病因及镜下表现。结果癌性心包炎90例,心包积液多为血性,符合镜下特征51例,临床病因诊断符合率56.7%;非特异性心包炎67例,诊断符合率56.7%;结核性心包炎22例,诊断符合率63.6%;化脓性心包炎8例,诊断符合率100%。术中曾出现心率减慢、血压偏低7例,气胸6例,腹膜损伤3例,偶发室性期前收缩30例,减压性肺水肿6例,经相应治疗或自行缓解。结论纤维心包镜对中大量心包积液的病因诊断有较大的实用价值。Objective To evaluate the role of pericardioscopy in the diagnosis of moderate or significant pericardial effusion. Methods One hundred and eighty-eight patients with unexplained moderate or significant pericardial effusion underwent subxiphoid pericardial fenestration and pericardioscopy examination to obtain etiologic data and visualization of pericardium. Results A total of 90 cases were diagnosed as malignant pericardial effusion, in which typical pericardioscopie features were found in 51cases and diagnostic agreement rate with clinical data was 56. 7% ; 67 cases were diagnosed as nonspecific pericarditis with diagnostic agreement rate of 56. 7% ; 22 cases were diagnosed as tuberculosis with diagnostic agreement rate of 63.6%; 8 cases were diagnosed as purulent effusion with diagnostic agreement rate of 100%. The complications included bradycardia and hypotension （7 cases）, pneumothorax （6 cases）, peritoneal injury （ 3 cases） , premature ventricular contractions （ 30 cases） and dysbaric pneumonedema （ 6 cases） , which were relieved by themselves or by relevant therapy. Conclusions Pericardioscopy has a practical value in the etiologic diagnosis of moderate or significant pericardial effusion.

关 键 词：内窥镜 心包积液 癌 

分 类 号：R542.12[医药卫生—心血管疾病]