改良Seldinger介入置管法治疗顽固性大量心包积液

Modified Seldinger Catheterization Technique for Pericardial Indwelling Catheter Drainage Large Refractory Pericardial Effusion

目的 :探求治疗顽固性大量心包积液 (RLPE)安全、有效、简便的置管引流方法。方法 :选用美国ARROW公司生产的中心静脉置管装置 ,在心超引导下 ,对 12例RLPE采用Seldinger’s经皮穿刺心包留置导管 ,进行全封闭适度负压持续引流。结果 :不仅装置简便、操作简化、定位准确 ,而且置管可靠、引流彻底、疗效确切 ,无不良反应及损伤。结论 :该介入置管法是对传统置管方法的改进 ,是目前RLPE科学和实用的引流治疗方法。

Objective: To seek an ideal pericardial indwelling tube drainage for the treatment of patients with large refractory pericardial effusion. Methods: The continuous catheter drainaging with proper pressure under echocardiographically guided seldinger's percutaneous technique was msually perfosmed by catheter (5F×20cm) and introduction syringe with core hole for guidewire etc. Without withdrawing the syringe coree and following the advance of the sheath as dilator, the treatment was undcetaken in 12 hospitalized patients with RLPE. Results: Pericardiocentesis procedure under echo-guidance was accurate and safe. Successful catheter drainage was achieved in all patients without any complications. The use of the modified catheter drainage was ended with extensive eomplete drainage, rapid symptomatic relief, simple operation and reliable stabilization. Conclusion:Our experiences indicate that the modofed technique in pericardial indwelling catheter dsainage should be considered as the best one in the present for the drainage of RLPE.