超声引导锥形套管针穿刺在心脏压塞救治中的应用

Application of Ultrasound-guided Cone-shaped Trocar Puncture for Cardiac Tamponade

目的 探讨超声引导下锥形套管针穿刺在心脏压塞救治过程中的应用价值。方法1998年3月～2015年10月，在超声引导下使用锥形套管针（专利号：ZL200620132265．8）对28例大量心包积液（心包积液宽度≥17mm）引起的心脏压塞进行心包穿刺，置入引流管引流。选择Seldinger法心包置管治疗心脏压塞患者28例作为对照组，比较2组的置管时间。结果所有心脏压塞患者均一次穿刺成功并置入引流管，锥形套管针组置管时间（6．2±1．1）min，比Seldinger组（15．0±1．1）min明显缩短（t=-27．844，P=0．000），引流后患者心脏压塞症状均消失。结论在大量积液引起的心脏压塞患者的救治过程中，超声引导下锥形套管针穿刺置管操作简便，创伤小，快速安全，疗效确切，也为后续治疗提供了保障。

Objective To discuss the value of cone-shaped trocar puncture under ultrasound guidance in the treatment of cardiac tamponade. Methods From March 1998 to October 2015, 28 patients with perieardial tamponade caused by massive pericardium effusion （the effusion width was more than 17 ram） underwent pericardiocentesis by using cone-shaped trocar （Patent No： ZL 2006 2 0132265. 8 ） puncture under ultrasound guidance and insertion of a drainage tube. Another 28 patients with cardiac tamponade receiving drainage placement by the Seldinger technique were selected as the control group. The time of catheterization was compared between the two groups. Results The puncture and drainage placement was successfully performed in one time in all the patients. The average time of catheterization in the trocar puncture group was significantly shorter than that in the control group [（6.2 ±1.1） minvs. （15.0±1.1） rain, t= -27.844, P=0.000]. The symptoms of cardiac tamponadedisappeared after catheter drainage. Conclusions For patients with cardiac tamponade with a large amount of pericardium effusion, use of cone-shaped troear puncture under ultrasound-guidance is simple, minimally invasive, quick, safe, and effective. It also provides the guarantee for subsequent treatments.