心脏移植术后心包积液的发生原因及处理方法探讨

Study on the pathogenesis and treatment of pericardial effusion after heart transplantation

目的 探讨心脏移植术后心包积液的发生原因及其处理方法。方法 通过超声心动图观察心脏移植术后长期存活的 5例受者心包积液的发生情况 ,同时对移植术后发生的心脏排斥反应、病原体感染、中心静脉压等进行检测 ,并观察这些指标与心包积液发生的的关系。结果 5例心脏移植的受者 ,均长期出现少量或中量心包积液。其中 1例受者在术后 1d出现心包积血。结论 心包积液与急性心脏排斥反应、感染及右心衰竭无显著相关性。术后 1w内出现的大量心包积液可能为心包积血 。

Objective To investigate the mechanism ofpericardial effusion after heart transplantation and the treatment. Methods The occurrence of pericardial effusion in 5 cases undergoing heart transplantation was observed by echocardiogram, meanwhile the rejection reaction and the pathogen were detected, and the central venous pressure (CVP) was measured. Results Mild or moderate pericardial effusion occurred in all the 5 cases, thereinto onecase suffered from pericardial effusion one day after transplantation. No relationship between pericardial effusion and acute rejection, infection and right ventricular failure was observed. Hemorrhagic effusion was found in one case. Conclusions Examination of pericardium should be made after heart transplantation regularly.Large amount of pericardial effusion whithin 1 week after transplantation is very likely to be hemorrhagic effusion and should be treated timely.