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[心脏手术后的继发性心包填塞(附3例报告)]

[Secondary tamponade following cardiac surgery with reference to 3 cases].

作者信息

Fournial G, Glock Y, Berthoumieu F, Desrez X, Cayre G, Henry E, Marco J

出版信息

Arch Mal Coeur Vaiss. 1979 Jul;72(7):806-12.

PMID:117780
Abstract

Secondary tamponnade after cardiac surgery occurs after a variable period, generally between the 15th day and the 5th post-operative week. Although this is a rare complication, it occurred three times in a consecutive series of 225 patients (1.3 p. 100). Based on this short experience as compared to the number of cases already published, the authors discuss their opinions on: -- the factors of inflammation and post-operative anticoagulation which predispose to this complication; -- the progress in diagnosis brought about by echocardiography; -- the minimal suggested management of pericardocentesis completed or not by surgical drainage; -- the possibilities of prevention based on prolonged follow-up of patients who present post-operative "pericardial problems". In this way it may be possible to eliminate a not negligeable cause of secondary mortality after cardiac surgery.

摘要

心脏手术后的迟发性心包填塞在一段可变的时间后发生,通常在术后第15天至第5周之间。虽然这是一种罕见的并发症,但在连续的225例患者中发生了3次(1.3%)。基于与已发表病例数相比的这段短暂经验,作者讨论了他们对以下方面的看法:——易导致该并发症的炎症和术后抗凝因素;——超声心动图在诊断方面取得的进展;——心包穿刺术(无论是否辅以手术引流)建议的最小化处理;——基于对出现术后“心包问题”患者的长期随访进行预防的可能性。通过这种方式,有可能消除心脏手术后继发性死亡的一个不可忽视的原因。

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