Seldinger技术指导心包穿刺置管引流治疗心包积液

Aplication of seldinger technique to guide percutaneous pericardial drainage with indwelling catheter in the management of pericardial effusion

目的评价Seldinger技术指导心包穿刺置管引流治疗中至大量心包积液的疗效及安全性。方法中到大量心包积液48例,在超声心动图定位下,采用Seldinger技术,经皮穿刺心包腔并内置深静脉留置导管进行持续或间断引流心包积液。结果48例患者均1次穿刺并留置导管引流成功,未出现因继发感染、出血、气胸、严重心律失常、心脏穿破及与心包穿刺置管导致的死亡。留置时间时间5～42(10.7±4.7)d,平均引流量为280～1750(590±160)ml。结论采用Seldinger技术心包穿刺置管引流治疗中至大量心包积液,方法简单,安全有效,成功率高,可替代传统穿刺方法。

Objectives To evaluate the effectiveness and safety of using seldinger technique to guide percutaneous pericardial drainage with indwelling catheter in the management of moderate and large pericardial effusion. Methods 48 patients with moderate and large pericardial effusion under the guide of echocardiography were percutaneously indwelled deep vein catheter for continuous or interval pericardial drainage using seldinger technique. Results Forty-eight patients were successfully percutaneously indwelled catheter drainage for pericardial effusion without the death complication associated with secondary infection, haemorrhage, pneumothorax, severe arrhythmia or perforation. Using pericardial indwelling catheter, the average drainage time were 5-42 （11±5） d, The drainage volume was 280-1750 ml, with the average of 590±160 ml. Conclusions The use of seldinger technique to guide percutaneous pericardial drainage with indwelling catheter is a simple, safe and effective way, and has high successful rate in the management of moderate and large pericardial effusion. It also can take the place of traditional methods.