心包炎患者心包切除术后的病因分析

目的 :探讨心包炎心包切除术后的病因诊断 ,以提高心包炎的临床诊断水平。方法 :回顾性分析 5 2例行心包切除术并有病理检查结果的心包炎临床与病理资料。结果 :结核性 14例 ( 2 6 .9%) ,癌性 4例 ( 7.7%) ,非特异性改变 34例 ,其中 2例为创伤性、1例为放射性 ,其他 31例 ( 5 9.7%)原因不能确定。与非特异性组比较 ,结核性心包炎患者的病程较短 (P <0 .0 1) ,有发热、急性心包炎、中至大量心包积液和心脏压塞病史者较多 (P <0 .0 5～0 .0 1) ;4例癌性心包炎均表现为顽固性渗液性心包炎。结论 :缩窄性心包炎多数病例病因不明 ,在已知的病因中 ,以结核多见 ;顽固性心包渗液多见于恶性肿瘤。

Etiological diagnosis of the patients with pericarditis after pericardiectomy

Objective To explore the etiological diagnosis of the patients with pericarditis after pericardiectomy to improve the clinical diagnosis. Methods The clinical and pathological data of 52 patients with pericarditis after pericardiectomy were a retrospective analyzed. Results Fourteen cases (26.9%) were tuberculous, 4 cases (7.7%) were cancerous and 34 cases presented as non-idiopathic changes. Of the non-idiopathic cases, 2 cases were traumatic pericarditis and 1 case was related to radiation, the cause of the other patients were of unknown. Compared with non-idiopathic group, the patients in tuberculous group had a shorter course (P<0.01). The histories of fever, acute pericarditis, pericardial effusion and cardiac tamponade were more frequent in the tuberculous group than in the non-idiopathic group (P<0.01～0.05). Four patients with cancerous pericarditis were all refractory pericardial effusion. Conclusion Most of constrictive pericarditis are of unknown cause, but in known causes tuberculosis has a high incidence. Refractory pericardial effusion is often seen in patients with malignant tumor.