不同程度肺动脉高压对超声引导下心包积液置管引流术治疗效果的影响

Influence of different degrees of pulmonary arterial hypertension on the treatment effect of ultrasound-guided pericardial effusion catheter drainage

目的探讨不同程度肺动脉高压对超声引导下心包积液置管引流术治疗效果的影响。方法选取2015年6月~2017年12月我院收治的74例肺动脉高压合并心包积液患者作为研究对象,按照肺动脉高压分级将其分为三组,即轻度组(30~<50 mmHg)(33例)、中度组(50~70 mmHg)(24例)与重度组(>70 mmHg)(17例)。比较三组患者手术前后的脉压差、心率、右房左右径、下腔静脉内径及三尖瓣环收缩期位移,并记录三组患者的治愈率。结果三组患者术前的脉压差、心率、右房左右径、下腔静脉内径、三尖瓣环收缩期位移比较,差异无统计学意义(P>0.05);与本组术前比较,三组患者术后1 d的脉压差、心率、右房左右径、下腔静脉内径、三尖瓣环收缩期位移均改善,且轻度组改善幅度大于中度组、重度组,中度组改善幅度大于重度组,差异有统计学意义(P<0.05)。轻度组患者的治愈率与中度组比较,差异无统计学意义(P>0.05);轻度组、中度组患者的治愈率均高于重度组,差异有统计学意义(P<0.05)。结论轻度肺动脉高压合并心包积液患者采用超声引导下心包积液置管引流术治疗,其效果较为显著,可有效优化脉压差、心率、右房左右径、下腔静脉内径及三尖瓣环收缩期位移,但在重度肺动脉高压患者的治疗中,效果不明显,故在临床应用中应根据患者的实际情况实施治疗。

Objective To investigate the influence of different degrees of pulmonary arterial hypertension on the treatment effect of ultrasound-guided pericardial effusion catheter drainage.Methods A total of 74 patients with pulmonary arterial hypertension and pericardial effusion admitted to our hospital from June 2015 to December 2017 were selected as research objects,and they were divided into three groups according to the classification of pulmonary arterial hypertension,namely the mild group(30-<50 mmHg)(33 cases),moderate group(50-70 mmHg)(24 cases)and severe group(>70 mmHg)(17 cases).The pulse pressure,heart rate,left and right diameter of right atrium,inferior caval vein diameter,and tricuspid annular plane systolic displacement before and after operation were compared among the three groups.The cure rate of the three groups of patients was recorded.Results Before operation,there were no significant differences in pulse pressure,heart rate,left and right diameter of right atrium,inferior caval vein diameter,and tricuspid annular plane systolic displacement among the three groups(P>0.05).Compared with before operation,the pulse pressure,heart rate,left and right diameter of right atrium,inferior caval vein diameter,and tricuspid annular plane systolic displacement at 1 d after operation in the three groups all improved,and the improvement of the mild group was greater than that of the moderate group and severe group,and the improvement of the moderate group was greater than that of the severe group,with statistically significant differences(P<0.05).There was no significant difference in the cure rate between the mild group and the moderate group(P>0.05).The cure rate of patients in the mild group and the moderate group was higher than that in the severe group,and the difference was statistically significant(P<0.05).Conclusion Ultrasound-guided pericardial effusion catheter drainage in the treatment of patients with mild pulmonary arterial hypertension combined with pericardial effusion has significant effect,it can optimize pulse pressure,heart rate,left and right diameter of right atrium,inferior caval vein diameter,and tricuspid annular plane systolic displacement.However,in the treatment of severe pulmonary arterial hypertension patients,the effect is not obvious.Therefore,in clinical application,treatment should be implemented according to the actual situations of the patients.