以腹腔积液为主要表现的缩窄性心包炎8例分析

An Analysis of Constrictive Pericarditis of 8 Patients with the Major Presentation of Ascites

目的分析以腹腔积液为主要表现的缩窄性心包炎的临床特点,加深消化科临床医生对缩窄性心包炎引起的腹腔积液的认识。方法选择我科从1993年1月到2008年5月间收治的以腹腔积液为主要表现的缩窄性心包炎病例,回顾性分析其一般资料、病程、症状和体征以及相关的影像学检查。结果我科15年共收治本病8例,症状以腹胀和浮肿为主,体征以颈静脉怒张为主,心电图检查均有不同程度的异常改变,超声心动图只确诊4例,CT或MRI8例均明确诊断。结论凡是消化科临床遇到的腹腔积液为主要表现的病人,一定要警惕缩窄性心包炎的可能,特别是要进行完善的体格检查如颈静脉怒张,并且对心电图有改变的患者一定要明确原因。

Objective To enhance clinical gastrointestinal physicians＇ understanding of ascites resulting from constrictive pericarditis by analyzing clinical features of. Methods A retrospective analysis was carried out in patients with constrictive pericarditis with the major presentation of ascites in our department of gastroenterology from January 1993 to May 2008. Medical records of these patients were reviewed, including data of demographics, course of desease, clinical presentation, relevant imaging studies and so on. Results There were 8 cases of constrictive pericarditis with the major presentation of ascites in our department of gastro - enterology in 15 years. The jug- ular varicosity was the most common manifestation in the 8 cases, followed by tabdominal distension and oedema. There were some abnormal changes in the electrocard - iography of the 8 cases. In 4 cases, no diagnosis was reached by the echocardiogram. In 8 cases,the definite diagnosis was reached by CT or MRI. Conclusion Cautions should be demanded for the patients with the major presentation of ascites in the department of gastroenterology owing to the possibility of constrictive pericarditis. In these patients, consummate physical examination is demanded such as the jugular varicosity. And the definite reason must be probed in the patients with the abnormal electrocardiographic changes.