血管镜直视经皮心包活检引流灌洗治疗心包积液

目的评价经皮血管镜直机心包活检引流灌洗术对心包积液的病因诊断、治疗、近期疗效随访结果。方法通过超声监测下经皮穿刺心包腔后用赛林格技术放入止血鞘，经鞘内放入血管镜目镜检查并改良技术在直视下活检取得标本，经用分子生物学，免疫组化等系列病理，病因检查确诊。经引流缓解心包填塞后进行病因针对性灌洗治疗。结果经临床160例应用病因诊断率达90％，恶性积液确诊率达93％，使心包积液近期治愈率达90％左右。结论此方法集诊断治疗一次完成。安全可靠，无严重的并发症。较以往方法有明显提高了诊疗效果。

Percutaneous Pericardial Biopsy Under the Direct Vision or Angioscope.Drainage and Lavage for Treatment of Pericardial Effusion

Objective it is aimed to investigate the feasibility of Percutaneous pericardial biopsy under the direct vision of angioscope,drainage,lavage for treatment of pericardial effusion. Methods Under ultrasonic cardiography guidance percutaneous pericardial puncture was completed, then hemostasis sheath was placed by Seldingers technique,through the sheath angioscope was inserted and observation was completed,under the direct vision,pericardial biopsies were taken by an Olympus biopsy forceps. Samples were examined by molecular-biology and serial of pathologic and pathogenesis methodes for diagnosis. After drainage to relieve pericardial tamponade, pathogenesis lavage was perfomed. Results 160 cases were enrolled.Etiologic dignosis is about 90% and malignent effusion is 93% and follow up 3-12 months cure-rate is 90%. No significant complication was found. Conclusion This is the first report in the literatures for treatment of pericardial effusion,it is safe and superior to conventional methods.