Subxiphoid pericardiostomy in the management of pericardial effusions:: case series analysis of 368 patients
Subxiphoid pericardiostomy in the management of pericardial effusions:: case series analysis of 368 patients
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DOI：
10.1136/hrt.2004.037499
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发表时间：
2005-06-01
期刊：
影响因子：
5.7
通讯作者：
Gürlertop, Y
中科院分区：
文献类型：
--
作者：
Becit, N;Ünlü, Y;Gürlertop, Y
目的：目的：探讨剑突下心包切开引流术在心包积液诊断和治疗中的应用价值。方法：对368例因心包填塞、中重度心包积液或可疑细菌性心包积液行剑突下心包切开引流术的患者进行回顾性分析。心包活检和液体样本的诊断tests.Results：患者的平均年龄为38.4岁，男性与女性的比例为220：148。超声心动图将53%的患者心包积液分为重度，43%为中度，4%为轻度。心包填塞发生率为25%。0.8%的患者发生需要胸骨切开术的心肌损伤作为手术并发症，10%的患者发生需要进一步手术干预的复发性积液。组织学检查和心包液标本的聚合酶链反应有助于90%的恶性肿瘤和92%的结核性心包炎的诊断。总体30天死亡率为0.8%。患者随访至少一年。心包收缩，需要心包切除术在3%的patients.Conclusions：各种原因的心包积液可以安全，有效，快速管理剑突下心包切开术在成人和儿童。
Objective: To assess the effectiveness of subxiphoid pericardiostomy in the treatment and diagnosis of pericardial effusions.Methods: 368 patients who underwent subxiphoid pericardiostomy and tube drainage for cardiac tamponade, moderate to severe pericardial effusion, or suspicious bacterial aetiology were retrospectively analysed. Biopsies of the pericardium and fluid samples for diagnostic tests were obtained from each patient.Results: The mean age of the patients was 38.4 years, and the male to female ratio was 220: 148. The pericardial effusion was classified by echocardiography as severe in 53% of the patients, moderate in 43%, and mild in 4%. The incidence of cardiac tamponade was 25%. Myocardial injury requiring sternotomy occurred as an operative complication in 0.8% of the patients and recurrent effusion necessitating further surgical intervention developed in 10% of patients. Histopathological examination and the polymerase chain reaction of specimens of pericardium and fluid were helpful for establishing a diagnosis in 90% of patients with malignancy and 92% of patients with tuberculous pericarditis. The overall 30 day mortality rate was 0.8%. Patients were followed up for at least one year. Pericardial constriction requiring pericardiectomy developed in 3% of the patients.Conclusions: Pericardial effusions of various causes can be safely, effectively, and quickly managed with subxiphoid pericardiostomy in both adults and children.