缩窄性心包炎术后早期预后的研究

Early operative results of pericardiectomy for constrictive pericarditis

目的 :研究影响缩窄性心包炎心包剥脱术早期预后的因素。方法 :分析了 2 5例心包剥脱术患者 ,结核性心包炎 2 0例 ,其中亚急性结核性心包炎 4例 ,开心术后及慢性透析患者各 1例 ,病因不明者 3例。依心功能将 2 5例患者分为改善组和非改善组 ,比较两组间的血液动力学变化和术前因素。结果 :在改善组 ,血液动力学的改善保持到术后早期 (术后 8d～ 10d) ,但非改善组血液动力学再度恶化 ,且心包积液和CRP的升高只出现在非改善组。结论 :认为缩窄性心包炎的病因和由心包炎引起的炎性反应程度与早期预后有关 ,加强抗炎治疗的同时早期手术可望取得良好的手术效果。

Objective:Early operative results of pericardiectomy for constrictive pericarditis was studied.Methods:Twenty-five patients were studied.They consisted of 20 with tuberculosis 4 with subacute tuberculosis,each of post cardiac surgery,chronic renal failure and 3 of unknown etilogy.The 25 patients were divided into improved(n=19) and not-improved groups(n=6).Hemodynamic changes and preoperative factors patent-related factors and laboratory date in these 2 groups were compared.Results:The immediate postoperative relief was maitained in the improved group,but central venous pressure(CVP)was re-elevated at discharge in the not-improved group.Pericardial affusion and elevation of CRP level were found only in the not-improved group.Conclusion:The etiology of the disease in volved and preoperative inflammation due to pericarditis influenced the early postoperative result.Therefore,early pericardiectomy should be accompanied by considerable use of anti-inflammatory regimens.