Outcomes of clinically significant idiopathic pericardial effusion requiring intervention
Outcomes of clinically significant idiopathic pericardial effusion requiring intervention
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DOI：
10.1016/s0002-9149(02)03408-2
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发表时间：
2003-03-15
影响因子：
2.8
通讯作者：
Seward, JB
中科院分区：
文献类型：
--
作者：
Tsang, TSM;Barnes, ME;Seward, JB
关于需要干预的特发性心包积液患者的结果数据很少。 1979 年至 2000 年间，所有经超声心动图证实有临床意义的心包积液且需要干预的患者均通过超声引导心包穿刺术登记处以及超声心动图和外科数据库进行识别。临床数据和结果是通过审查医疗记录和调查获得的。研究人群包括 92 名患者（平均年龄 59 +/- 15 岁）。 5 名患者被直接转诊进行心包切除术（3 名患者因慢性复发性心包炎而出现积液，2 名患者患有渗出性缩窄性疾病），87 名患者接受了超声引导心包穿刺术作为初始治疗。其中 47 名患者的主要治疗涉及扩大心包导管引流，与不进行导管引流的患者相比，这与复发率较低的趋势相关 (p = 0.052)。 3名患者出现短暂性右心室进入，无后遗症，7名患者（8%）后来因积液复发而接受了心包切除术，其中2名患者在手术中还发现有渗出性缩窄性疾病的证据。一名患者在心包切除术后出现出血，需要再次开胸手术。该队列的平均随访时间为 3.8 +/- 4.3 年。对于大多数需要干预的临床显着特发性心包积液患者，超声引导心包穿刺术是最终的治疗方法。对于因渗出性缩窄、疾病、慢性复发性心包炎或心包穿刺术后仍反复出现积液的患者，需要进行心包切除术。该队列的预后良好，生存率似乎与一般人群没有差异（p = 0.372）。 (C) 2003 年，Excerpta Medica, Inc.
There is a paucity of outcome data on patients with idiopathic pericardial effusion requiring intervention. All patients who had clinically significant pericardial effusion confirmed by echocardiography and requiring interventions between 1979 and 2000 were identified through the Echo-guided Pericardiocentesis Registry and Echocardiography and Surgical Databases. Clinical data and outcomes were obtained by review of medical records and surveys. The study population consisted of 92 patients (mean age 59 +/- 15 years). Five patients were referred directly for pericardiectomy (3 had effusion in the context of chronic relapsing pericarditis, 2 had effusive constrictive disease), and 87 underwent echo-guided pericardiocentesis as thier initial treatment. In 47 of these patients, primary management involved extended pericardial catheter drainage, which was associated with a trend to lower recurrence rates than in those without catheter drainage (p = 0.052). Three patients had transient right ventricular entry with no sequelae, and 7 patients (8%) later had surgical pericardiectomy because of the recurrence of effusion, 2 of whom were also found to have evidence of effusive constrictive disease during surgery. One patient had bleeding after pericardiectomy that required repeat thoracotomy. Mean follow-up of the cohort was 3.8 +/- 4.3 years. For most patients with clinically significant idiopathic pericardial effusion requiring intervention, echo-guided pericardiocentesis was the definitive treatment. Pericardiectomy was necessary for patients in whom effusion occurred in the context of effusive constrictive, disease, chronic relapsing pericarditis, or recurrent effusion despite pericardiocentesis. The prognosis for the cohort was favorable, and survival did not appear to differ from that of the general population (p = 0.372). (C) 2003 by Excerpta Medica, Inc.