剑突下心包开窗术治疗大量心包积液

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年期间收治的３０例大量心包积液或心包填塞塞患者诊闻过程。所有患者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 引渡以后患者症状改善,８３％的２下平卧或下床活动。术中心包积液引流量为２００－２０００ｍｌ术后引流量０－２０００ｍｌ,引流时间２－３０ｄ,平均拔管时间为５．６ｄ,拔管

Subxiphoid pericardial window drainage in the management of large pericardial effusions

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 200-2,000 ml, and postoperation was 0-2,000 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.