Tomimaru Yoshito, Kodama Ken, Okami Jiro, Oda Kazuyuki, Takami Koji, Higashiyama Masahiko
Department of Thoracic Surgery, Osaka Medical Center for Cancer and Cardiovascular Diseases, Osaka, Japan.
Jpn J Thorac Cardiovasc Surg. 2006 May;54(5):193-8. doi: 10.1007/BF02670311.
Postoperative pericardial effusion commonly occurs after open heart surgery. However, after general thoracotomy such as pulmonary resection, there have been few reports of pericardial effusion. The purpose of this study is to investigate patients with pericardial effusion following pulmonary resection.
Among 2,385 patients with pulmonary resection for lung neoplasm in our institute, eight patients, whose pericardium had never been opened during the operation, developed pericardial effusion. The clinical characteristics of the eight patients were analyzed.
Pericardial effusion after pulmonary resection was divided into two subtypes: pericardial effusion in three patients with left thoracotomy occurring within 30 days postoperatively, and pericardial effusion in the remaining five patients with right thoracotomy occurring more than 30 days postoperatively. Pericardiotomy or pericardiocentesis was performed in three symptomatic patients, and the remaining five asymptomatic patients were treated with diuretics. Pericardial effusion disappeared in three of the five patients about 1-3 months after the conservative treatment, while, in the remaining patients, because pericardial effusion had increased gradually, pericardiocentesis was performed.
From our experience, the treatment strategy of drainage for early pericardial effusion and diuretics for late pericardial effusion seems to be appropriate.
心脏直视手术后常发生术后心包积液。然而，在诸如肺切除等普通开胸手术后，心包积液的报道较少。本研究的目的是调查肺切除术后发生心包积液的患者。
在我院2385例行肺肿瘤切除术的患者中，有8例患者在手术过程中心包未被打开，但发生了心包积液。对这8例患者的临床特征进行了分析。
肺切除术后心包积液分为两种亚型：3例左胸手术患者的心包积液发生在术后30天内，其余5例右胸手术患者的心包积液发生在术后30天以上。3例有症状的患者进行了心包切开术或心包穿刺术，其余5例无症状患者接受了利尿剂治疗。5例患者中有3例在保守治疗后约1 - 3个月心包积液消失，而其余患者由于心包积液逐渐增多，进行了心包穿刺术。
根据我们的经验，早期心包积液引流和晚期心包积液使用利尿剂的治疗策略似乎是合适的。
