112例结核性缩窄性心包炎外科治疗的临床分析  

Surgical Treatment for 112 Patients with Tuberculous Constrictive Pericarditis

作　　者：陈杰 罗勇[1] 袁武[1] 陈剑[1] 李金泽 程力剑 Chen Jie;Luo Yong;Yuan Wu(Cardiac and Vascular Surgery Department,the Third People's Hospital of Chengdu,Chengdu,Sichuan 610031,China)

机构地区：[1]成都市第三人民医院心脏大血管外科,四川成都610031

出　　处：《四川医学》2024年第10期1057-1060,共4页Sichuan Medical Journal

基　　金：四川省卫健委普及科研项目(编号:19PJ011)。

摘　　要：目的总结我院结核性缩窄性心包炎患者行外科手术治疗的经验,分析手术相关危险因素以及患者的临床预后。方法2005年1月至2018年12月,共计112例结核性缩窄性心包炎患者在我院行手术治疗。回顾性分析患者临床资料,对术后随访数据进行统计分析。结果患者院内死亡率为3.6%。患者术前症状持续时间<1年的62例,占55.4%,早期死亡率明显低于症状>1年的患者(P<0.05)。术前左室射血分数(LVEF)≥50%的患者早期死亡率明显低于LVEF<50%的患者(P<0.01)。再次心包剥脱手术患者的早期死亡率明显高于首次手术患者(P<0.01)。术后中位随访时间51月,患者术后5年生存率为91.9%,10年生存率为84.8%。结论外科手术治疗结核性缩窄性心包炎是安全有效的,手术能明显改善患者的心脏功能。Objective The aim of the study was to review the experience on surgical treatment for tuberculous constrictive pericarditis(TCP)and to analyze the clinical outcome and risk factors.Methods A retrospective and postoperative follow-up data analysis was carried out in 112 consecutive patients who underwent surgical treatment for TCP in our hospital from January 2005 to December 2018.Results The hospital mortality was 3.6%.The preoperative duration of symptoms<1 year in 62 patients,accounting for 55.4%,the early mortality was significantly lower than that of patients with symptoms>1 year(P<0.05).The early mortality of patients with left ventricular ejection fraction(LVEF)≥50%before operation was significantly lower than that of patients with LVEF<50%(P<0.01).The early death rate of the patients with repericardial dissection was significantly higher than that of the patients with the first operation(P<0.01).The median follow-up time was 51 months.The 5-year survival rate was 91.9%and the 10-year survival rate was 84.8%.Conclusion Surgical intervention is a safe and reliable treatment and surgery can significantly improve the heart function of patients with TCP.

关 键 词：结核性心包炎 缩窄性心包炎 心包剥脱术 

分 类 号：R542.11[医药卫生—心血管疾病]