浅析心脏介入性治疗中并发心脏压塞的原因及诊断治疗

Analysis of the Causes of Cardiac Tamponade During Cardiac Interventional Therapy and Its Diagnosis and Treatment

目的对心脏介入性治疗中并发心脏压塞的原因、诊断及治疗方法进行研究分析,为临床治疗提供参考。方法我院对487例心脏介入性治疗患者进行了研究分析,根据患者的表现、超声心动图检查、X线检查来对心脏压塞情况进行检查。如果患者有心脏压塞症状,需要停止心脏介入治疗,使用心包穿刺术引流、心包切开引流术、冠状动脉搭桥术和冠状动脉修补术等治疗方式。结果全部患者共出现了3例心脏压塞并发症病例,占总数的0.62%。患者的发病原因是房间隔穿刺时误穿左心房壁、左心房壁受损,冠状动脉破裂及心包压塞。经X线检查共检查出2例病例,另一例无异常,经超声诊断才确诊。3例患者分别使用了心包穿刺术治疗,心包切开引流术治疗,冠状动脉搭桥术和破裂冠状动脉修补术,均无不良反应情况出现,患者的血流动力学指标无以成,恢复良好。结论心脏压塞是心脏介入性治疗中比较危险的并发症,及时的发现快速寻找病因采取针对性处理措施是治疗的关键,能确保患者的预后。

Objective To study the causes, diagnosis and treatment of cardiac tamponade in interventional therapy, so as to provide reference for clinical treatment. Methods In our hospital, 487 patients with cardiac interventional therapy were studied and analyzed. The cardiac tamponade was examined according to the patient＇s performance, echocardiography and X-ray examination. If a patient has symptoms of cardiac tamponade, cardiac interventions should be performed by means of pericardial, drainage, pericardial incision, drainage, coronary artery bypass grafting, and coronary artery repair. Results A total of 3 cases of cardiac tamponade occurred in all patients, accounting for 0.62% of the total. The cause of the disease was the atrial septal puncture, the left atrial wall, the left atrial wall, the coronary artery rupture and the pericardial tamponade. After X-ray examination, 2 cases were found and another case had no abnormality. The diagnosis was confirmed by ultrasonic diagnosis. 3 patients were using the pericardium puncture treatment, pericardial incision and drainage for the treatment of coronary artery bypass grafting, and rupture of coronary artery repair, there were no adverse reactions, the hemodynamic indicators of patients to restore good. Conclusion Cardiac tamponade is a relatively dangerous complication of cardiac interventional therapy. Prompt detection, rapid detection of the cause and targeted treatment are the key to the treatment,which can ensure the prognosis of the patients.