超声引导下心包置管在创伤性心包压塞中的应用

Application of ultrasound-guided catheterization in the treatment of traumatic pericardial tamponade

目的 探讨心包置管在治疗创伤性心包压塞中的应用价值。 方法 1998年 3月～ 2 0 0 3年 9月 ,我们对 9例创伤性心包压塞在超声引导下穿刺积血心包 ,置入导管 ,通过导管抽出心包积血 ,然后及时引流心包内出血。 结果 置管引流后 ,病人的压塞症状明显好转。 4例在引流 4～ 8h内行心脏修补术 ,2例创伤好转后择期手术 ,2例引流后痊愈 ,1例因颅脑创伤严重而死亡。 结论 该方法安全可靠 ,能迅速缓解创伤性心包压塞症状 ,为心脏修补手术创造较好的条件和较充分的时间 ,部分病人可以避免手术。

Objective To evaluate the value of ultrasound-guided catheterization in the treatment of traumatic pericardial tamponade. Methods Nine patients with traumatic pericardial tamponade underwent ultrasound-guided catheterization from March 1998 to September 2003. After the drawing-off of fluid, the catheter was remained in the pericardium to drain the blood. Results The catheterization and drainage gave marked relief from symptoms. Surgical repairs of heart were performed in 4 patients within 4～ 8 h following drainage. Selective operations were required in 2 patients after the improvement of their conditions. Two patients were cured by drainage and 1 patient died of severe brain trauma. Conclusions The technique may produce prompt relief from symptoms of traumatic pericardial tamponade, being a safe and reliable procedure. It may create favorable conditions for further surgical repair or even freedom from operations.