缩窄性心包炎155例临床病理分析

ANALISIS OF 155 PATIENTS WITH CONSTRICTIVE PERICARDITIS

分析经手术证实的缩窄性心包炎155例,主要病因为结核,其次为化脓性,有些病理检查未找到结核或化脓性证据的急性病例可能系病毒性病因。手术发现,心包纤维坛生可在某一局部形成缩窄环,如房室环,左室及右室流出道等部位,临床易误诊为心脏瓣膜或流出道狭窄。应予重视。

Surgery confirmed 155 cases of constrictive pericarditis were analyzed. There were 121 males and 34 females. Average age 23.5 years. Pericardiectomy was performed through 1966 to 1986, and the pericardial specimen had pathohistologic examination. Pericardium showed fibrotic thickening and the etiologic diagnosis was tuberculous in 63 cases (40.6%), purulent 16 (10.3%), rheumatic 2 (1.3%) and one neoplastic (0.63%) Etiology of the remaining cases were not clarified, in which there were 10 cases that had a less than six months clinical course and were attributed to acute disease, as evidence of tuberculousis was absent, so that viral infection speculated. It was revealed that constriction can be localized at atrioventricular groove (8 cases), right ventricular infundibulum (11), left ventricular outflow tract (3) , the resulting murmurs mimic mitral stenosis, aortic stenosis or infundibular pulmonary stenosis, misdiagnosis was common.