缩窄性心包炎的外科治疗(附53例报告)

Surgical Management of Chronic Constrictive Pericarditis

目的 :总结分析缩窄性心包炎的手术治疗经验。方法 :回顾性分析 1993年 1月～ 2 0 0 4年 2月我科收治的 5 3例缩窄性心包炎患者的临床资料 ,所有患者均进行了心包切除术 ,其中男 37例 ,女 16例。年龄 7～ 78岁 ,平均 37 0 9± 19 2 7岁。心功能Ⅱ级 7例 ,Ⅲ级 36例 ,Ⅳ级 10例。经术前准备后行心包切除术。结果 :术后低心排 6例 ,出现心律紊乱 17例 ,死于低心排、肾功能衰竭 1例 ,死亡率 1 9% ,2 9例治愈 ,术后 4 8例 (占 91% )患者被随访 2～ 36个月无缩窄复发。结论 :把握手术时机、充分的术前准备及适当的术中、术后处理是保证手术效果的关键。

Objective: To summarize the experience of surgical treatment of chronic constrictive pericarditis. Methods:From Jan. 1993 to Feb. 2004, 53 chronic constrictive pericarditis patients aged 7～78 years, 37 males and 16 females, underwent surgical treatment. Seven patients appeared cardiac function Ⅱ grade, 36 cases Ⅲ grade and 10 cases Ⅳgrade.Pericardiectomy was done under general anesthesia following adequate preoperative preparation (and detailed consideration) . All clinical data were retrospectively analyzed.Resuts:Low cardiac output appeared in 6 cases, arrhythmia in 17 cases and one case died of low cardiac output and renal failure immediately after operation. Forty-eight cases were followed up, lasting 2 months to 36 months.Conclusions:Proper selection, early detection, adequate preoperative preparation, and correct management of postoperative complications are important to improve surgical outcome.