Hamid Mohammad, Khan Mueen Ullah, Bashour Allen C
Department of Anaesthesia, Aga Khan University Hospital, Karachi.
J Pak Med Assoc. 2006 Mar;56(3):104-7.
To investigate the effectiveness of X-ray and echocardiography (ECHO) as a diagnostic tool for cardiac tamponade in adult cardiac surgery patients.
Thirty five coronary artery bypass and graft surgery patients who developed cardiac tamponade at Cleveland clinic foundation, were included in this study. Their diagnosis was confirmed at the time of re-exploration in the operating room. These patients were followed retrospectively for demographics, X-ray and echocardiography findings. Abnormal and enlarged cardiac silhouette which was different from first postoperative X-ray was used as radiological criteria for tamponade while echocardiographic diagnosis was left to the discretion of cardiologist.
Twenty four males (69%) and 11 (31%) females with an average age of 60.7 +/- 15.2 years were included in this study. Only 7 (20%) patients met our criteria for radiological diagnosis of tamponade. All 35 patients showed pericardial effusion on ECHO while cardiac tamponade was present in 30 (86%) patients. Tamponade developed on an average on 4th postoperative day.
Radiological diagnosis of cardiac tamponade based on changes in cardiac silhouette provide limited information while ECHO is a reliable diagnostic tool when combined with clinical findings.
探讨X线和超声心动图（ECHO）作为诊断成年心脏手术患者心包填塞的工具的有效性。
本研究纳入了克利夫兰诊所基金会35例发生心包填塞的冠状动脉搭桥手术患者。他们的诊断在手术室再次探查时得到证实。对这些患者进行回顾性随访，了解其人口统计学资料、X线和超声心动图检查结果。与术后首次X线片不同的异常增大的心影被用作心包填塞的放射学标准，而超声心动图诊断则由心脏病专家酌情决定。
本研究纳入了24例男性（69%）和11例女性（31%），平均年龄为60.7±15.2岁。只有7例（20%）患者符合我们心包填塞的放射学诊断标准。所有35例患者超声心动图均显示心包积液，其中30例（86%）存在心包填塞。心包填塞平均在术后第4天发生。
基于心影变化的心包填塞放射学诊断提供的信息有限，而超声心动图结合临床 findings是一种可靠的诊断工具。
