Kameyama Kotaro, Huang Cheng-long, Okamoto Taku, Ishikawa Shinya, Yamamoto Yasumichi, Yokomise Hiroyasu
Second Department of Surgery, Kagawa Medical University, Kita-gun, Kagawa, Japan.
Jpn J Thorac Cardiovasc Surg. 2004 Feb;52(2):68-70. doi: 10.1007/s11748-004-0086-z.
A 72-year-old woman was admitted with chest discomfort and general fatigue. She was diagnosed as having cardiac tamponade with massive pericardial effusion. Percutaneous pericardiocentesis yielded bloody effusion. Tuberculous pericarditis was suspected owing to the adenosine deaminase level in this fluid. Video-assisted thoracoscopic pericardial fenestration (VATSPF) was performed for the diagnosis and treatment. Polymerase chain reaction detected Mycobacterium tuberculosis DNA in the pericardial tissues, confirming the diagnosis of tuberculous pericarditis. She received a combination of three-kind medication and anti-tuberculous regimen, and a follow-up check up for more than 2 years, exhibiting a good postoperative course. We conclude that VATSPF can be a useful procedure not only for diagnosis but for release of tuberculous pericarditis with cardiac tamponade and for prophylaxis of constrictive pericarditis.
一名72岁女性因胸部不适和全身乏力入院。她被诊断为心脏压塞伴大量心包积液。经皮心包穿刺抽出血性积液。由于该液体中的腺苷脱氨酶水平，怀疑为结核性心包炎。为进行诊断和治疗，实施了电视辅助胸腔镜心包开窗术（VATSPF）。聚合酶链反应在心包组织中检测到结核分枝杆菌DNA，证实了结核性心包炎的诊断。她接受了三联药物和抗结核治疗方案，并进行了2年多的随访检查，术后病程良好。我们得出结论，VATSPF不仅对诊断有用，而且对伴有心脏压塞的结核性心包炎的解除以及缩窄性心包炎的预防也有用。
