CT导向下心包穿刺置管引流术治疗心包积液23例

CT-guided pericardiocentesis together with catheter drainage for the treatment of pericardial effusion: report of 23 cases

目的初步探讨CT导向下心包穿刺置管引流的临床价值。方法回顾分析23例经CT导向下心包穿刺置管引流的心包积液患者临床资料。记录并对比患者置管引流手术前后的血压、心率及氧饱和度,术后临床症状改善情况及穿刺相关并发症的发生率。结果 23例患者均1次心包置管引流成功。术中3例患者感觉轻度胸疼,术后临床症状均明显缓解及无穿刺并发症的发生;心包置管引流前后患者的心率减慢,由(91.7±12.5)次/min降至(86.7±9.6)次/min(P<0.05),收缩压由(104.3±16.4)mmHg升至(107.4±13.6)mmHg(P<0.05)。结论 CT导向下心包穿刺置管引流术穿刺具有成功率高、并发症率低、准确且有效等特点,值得临床应用。

Objective To preliminarily investigate the clinical value of CT-guided pericardiocentesis and catheter drainage in treating pericardial effusion.Methods CT-guided pericardiocentesis together with catheter drainage was carried out in 23 patients with pericardial effusion.The clinical data were retrospectively analyzed.The blood pressure,heart rate and oxygen saturation were determined before and after the treatment.The improvement of clinical symptoms was evaluated and the puncture-related complications were documented.Results CT-guided pericardiocentesis together with catheter drainage was successfully completed with single procedure in all 23 cases.During operation three patients complained of mild chest pain.After the therapy the clinical symptoms were distinctly relieved,and no puncture-related complications occurred.The heart rate decreased from preoperative（91.7 ± 12.5） bpm to postoperative（86.7 ± 9.6） bpm（P 0.05）,and the systolic blood pressure rose from preoperative（104.3 ± 16.4） mmHg to postoperative（107.4 ± 13.6） mmHg（P 0.05）.Conclusion CT-guided pericardiocentesis together with catheter drainage is technically reliable and clinically effective with fewer complications.Therefore,this technique should be recommended in clinical practice.