经皮冠状动脉介入治疗并发急性心包填塞的临床分析

A analysis on acute cardiac tamponade in percutaneous coronary intervention

目的:分析和探讨冠心病介入治疗(PCI)并发急性心包填塞(ACT)的原因、诊断和处理方法。方法:回顾性分析1546例冠状动脉患者PCI中ACT的发生率、原因和诊断处理方法。结果:在1546例行PCI的患者中,根据临床表现及超声心动图检查,证实有5例因冠状动脉穿孔并发ACT,发生率为0.32%。5例全部行心包急诊穿刺引流,无一例死亡。结论:PCI中应尽早期发现ACT,并及时心包穿刺及持续引流,可以避免外科开胸手术治疗。

Objective：To analyze the cause, diagnosis and experience during the treatment of acute cardiac tamponade （ACT） in percutaneous coronary intervention. Method： In a retrospective analysis, we investigated the cause and summarized the process of diagnosis and treatment of ACT in 1546 consecutive patients with PCI from March 1995 to December 2003. Result：There were total 5 cases complicated with ACT in 1546 patients with incidence of 0. 32%. 5 were performed emergency pericardiocentesis. None of them died. Conclusion： Incidence of ACT is low in cardiac intervention. Early discovery and appropriate management can avoid operation.