Schafer M, Lepori M, Delabays A, Ruchat P, Schaller M-D, Broccard A F
Intensive Care Division, Centre Hospitalier Universitaire Vaudois, 1011 Lausanne CHUV, Switzerland.
Cardiovasc Surg. 2002 Oct;10(5):508-11. doi: 10.1016/s0967-2109(02)00067-4.
A 39-year-old man was admitted for upper abdominal pain and shortness of breath. The chest roentgenogram demonstrated cardiomegaly and left lower lobe atelectasis. Echocardiography showed circumferential pericardial effusion with signs of cardiac tamponade. Pericardial biopsy and fluid analysis were consistent with fibrino-purulent pericarditis. Despite broad-spectrum antibiotics, percutaneous and subsequently surgical drainage, pericardial effusion and tamponade recurred. We report successful treatment of a non-resolving fibrino-purulent pericardial effusion by combined intrapericardial irrigation of fibrinolytics and systemic corticosteroids administration as an alternative to pericardectomy.
一名39岁男性因上腹部疼痛和呼吸急促入院。胸部X线片显示心脏扩大和左肺下叶肺不张。超声心动图显示心包周向积液并有心脏压塞的迹象。心包活检和液体分析与纤维蛋白性脓性心包炎相符。尽管使用了广谱抗生素、经皮引流以及随后的手术引流，但心包积液和心脏压塞仍反复出现。我们报告了通过心包内联合灌注纤维蛋白溶解剂和全身应用皮质类固醇成功治疗难治性纤维蛋白性脓性心包积液的病例，以此作为心包切除术的替代方法。
