Sugimoto T, Shimanuki T, Minowa T, Uchino H, Nakamura C, Uchimura F, Haga T
Department of Surgery, Yamagata Prefectural Nihonkai Hospital, Yamagata, Japan.
Kyobu Geka. 1999 Mar;52(3):192-6.
Delayed cardiac tamponade is an unusual but serious complication of cardiac surgery. Echocardiography and computed tomography (CT) are well established methods for the detection of pericardial effusions. Catheter insertion guided by CT has been used to accomplish non operative drainage of symptomatic postoperative pericardial effusion in seven cases. These patients were grouped into four types according to distribution of the fluid. General pericardial effusion around the heart is classified as type 1, effusion adjacent to the right side of the heart as type 2 and left side as type 3, effusion localized only at the apex as type 4. CT imaging is useful not only to localize and assess the size of the effusions, but also to select the way of catheter insertion. As the fluid might be trapped in compartments, for instance right-sided or left sided type, investigation of the pericardial spaces is important in planning a catheter pericardiocentesis.
迟发性心脏压塞是心脏手术中一种不常见但严重的并发症。超声心动图和计算机断层扫描(CT)是检测心包积液的成熟方法。在CT引导下插入导管已用于7例有症状的术后心包积液的非手术引流。根据积液分布,这些患者分为四种类型。心脏周围的全身性心包积液分类为1型,心脏右侧相邻的积液为2型,左侧为3型,仅局限于心尖的积液为4型。CT成像不仅有助于定位和评估积液大小,还有助于选择导管插入方式。由于积液可能被困在腔隙中,例如右侧或左侧类型,在心包腔穿刺置管计划中,对心包间隙的检查很重要。