经皮心包穿刺置管持续引流治疗心包积液疗效观察

Observation of Effectiveness and Safety of Percutaneous Pericardial Drainage with Indwelling Catheter

目的探讨经皮心包穿刺置管持续引流心包积液的疗效及安全性。方法回顾太和县人民医院2002年7月-2010年10月收治的87例心包积液患者,其中36例中等量和大量心包积液的患者,采用经皮心包穿刺置管国产规格为5Fr216cm一次性使用中心静脉导管持续引流。患者经CT或超声诊断和定位后,在病房床边心电监护下,患者取半卧位,选择剑突下或胸骨旁或心尖部为穿刺点,常规消毒、铺巾,2%利多卡因局麻,采用Seldinger技术穿刺心包,置单腔或双腔中心静脉导管行心包持续引流及通过置入导管于心包腔内引流或给药或冲洗。结果 36例患者均于病房床边置管成功,留置时间平均8d(5～16d),均无组织脏器损伤及感染。2例发生导管堵塞,经肝素生理盐水冲洗后再通。结论经皮心包穿刺置管持续引流是安全、简捷、有效的诊断和治疗心包积液方法。

Objective To investigate the effectiveness and safety of percutaneous pericardial drainage with indwelling catheter.Methods 87 cases of patients with pericardium effusion from July 2002 to October 2010 in our hospital were reviewed,including 36 cases with medium or a large amount of effusion,the pericardium effusion was treated with domestic 5Fr2 /16 cm tube for drainage.After CT and ultrasound diagnosis,with the bedside ECG monitoring,the patient took a rest place,was pierced with seldinger technology;let a single or double a centre line for the tube with the pericardium drainage.Results 36 patients were successfully treated with percutaneous pericardial drainage in the ward,with encumbrance time averaged eight days（5-16 days）,no organ damage or infection occurred.Conclusion Percutaneous pericardial drainage was a safe and effective method in the diagnosis and treatment of pericardium effusion.