Gatenby R A, Hartz W H, Kessler H B
Department of Radiology, Jeanes Hospital, Philadelphia, PA 19111.
J Vasc Interv Radiol. 1991 Feb;2(1):151-5. doi: 10.1016/s1051-0443(91)72490-1.
Ultrasound (US)-guided and fluoroscopically guided pericardial catheter placement was performed in 12 patients with known underlying malignancy who had clinical and radiographic evidence of a significant pericardial effusion. US guidance facilitated placement of a 22-gauge needle by means of a subxyphoid or transthoracic approach. The tract was subsequently dilated over a wire under fluoroscopic guidance with placement of either an 8.5- or 10-F catheter. This technique successfully established pericardial drainage in all patients with excellent symptomatic relief. Cytologic findings were positive for malignancy in 10 of the 12 patients. Radiologically guided pericardiocentesis allowed safe, rapid stabilization of the condition of patients with symptoms from pericardial effusion. This resulted in excellent palliation in patients with terminal disease and improvement in the clinical status of other patients so that additional therapies, such as sclerosis with tetracycline or surgical placement of a pericardial window, could be performed on an elective basis.
对12例已知患有潜在恶性肿瘤且有临床和影像学证据表明存在大量心包积液的患者进行了超声（US）引导和荧光镜引导的心包置管。超声引导通过剑突下或经胸途径便于置入22号针。随后在荧光镜引导下通过导丝扩张通道，并置入8.5或10F导管。该技术在所有患者中均成功建立了心包引流，症状缓解良好。12例患者中有10例细胞学检查结果为恶性。放射学引导的心包穿刺术可使有心包积液症状的患者安全、快速地病情稳定。这使得晚期疾病患者得到了极好的姑息治疗，其他患者的临床状况也得到改善，从而可以择期进行四环素硬化或心包开窗手术等其他治疗。
