急诊超声引导下经皮心包穿刺置管引流术对心包积液的临床价值  

Clinical value of urgent percutaneous pericardial catheter drainage under the guide of echocardiography in pericardial effusions

作　　者：朱震豪[1] 林晓红[1] 项靖楠[1] 黄学峰[1] 郑伟达[1] 郑华[1] 

机构地区：[1]福建医科大学附属协和医院急诊科,福州350001

出　　处：《山西医科大学学报》2014年第11期1091-1093,共3页Journal of Shanxi Medical University

摘　　要：目的 探讨急诊超声引导下经皮心包穿刺置管引流术对不明原因心包积液的临床诊断、治疗价值. 方法 分析2011-10 ～2014-03我院急诊科收治的25例不明原因的中到大量心包积液患者应用超声引导下经皮心包穿刺置管引流术的临床资料,其中男18例,女7例. 结果 25例患者均一次性穿刺置管成功,症状迅速减轻.经检查确定病因：恶性肿瘤性13例（52％）,结核性3例（12％）,心力衰竭性4例（16％）,甲状腺功能减退性2例（8％）,尿毒症性2例（8％）,系统性红斑狼疮1例（4％）.导管留置时间平均8 d（5-26 d）,均无发生感染、组织脏器损伤等严重并发症. 结论 急诊超声引导下经皮心包穿刺置管引流术不仅是一项简便、安全、有效、经济的治疗心包积液的方法,而且有助于临床尽快明确心包积液的病因,从而达到急诊有效分流,标本兼治的目的.Objective To explore the clinical value of urgent percutaneous pericardial catheter drainage under the guide of echocardiography in the early diagnosis and treatment of pericardial effusions with unknown reasons.Methods The operations of urgent percutaneous pericardial catheter drainage under the guide of echocardiography were performed on 25 patients（7 female and 18 male） with moderate or a large amount of pericardial effusions of unknown reasons from October 2011 to March 2014 in the department of emergency of our hospital.The clinical data were analyzed.Results The procedures of urgent percutaneous pericardial catheter drainage were successful once in all 25 patients and their symptoms were relieved rapidly.Of 25 cases,malignancy was confirmed in 13 cases （52％）,tuberculosis in 3 cases（12％）,heart failure in 4 cases（16％）,hypothyroidism in 2 cases（8％）,uremia in 2 cases（8％） and systemic lupus erythematosus（SLE） in one case.The catheters were remained for 5-28 d（mean 8 d）.No severe complications of infection,tissues or organs injury were found.Conclusion The operation of urgent percutaneous pericardial catheter drainage under the guide of echocardiography not only is a relatively simple,safe,effective,economic therapy for pericardial effusion,but also is helpful to find quickly a definite diagnosis of pericardial effusion of unknown reasons in clinic for achieving appropriate triage of patients and the purpose of tackling the problem.

关 键 词：心包积液 心包穿刺 置管引流 

分 类 号：R605.97[医药卫生—急诊医学]