Mostbeck G H, Korn M, Wittich G R, Walter R M, Gebauer A, Schurawitzki H, Tscholakoff D
Ludwig-Boltzmann-Institut für radiologisch-physikalische Tumordiagnostik, Wien.
Rofo. 1991 Jul;155(1):53-7. doi: 10.1055/s-2008-1033218.
The results of 25 ultrasonographically guided percutaneous pericardial drainage procedures and of one pericardiocentesis performed in 25 patients with pericardial fluid collections are reported. After initial puncture of the pericardial cavity under sonographic guidance, dilatation and placement of 5F to 8.3F catheters in Seldinger technique was controlled fluoroscopically in 22 procedures. Clinical indications were emergency treatment of tamponade (n = 6) or urgent treatment of large (n = 14) pericardial effusions. The remaining 6 procedures were performed to establish specific diagnoses of small effusions. Puncture sites were subxiphoid in 23 and left parasternal in 3 cases. The volume of aspirated fluid ranged from 20 to 1710 ml (median: 615 ml). Median duration of pericardial drainage was 3 days (range less than 1 day to 21 days). A specific diagnosis was obtained in 48% of patients. 4 patients had subsequent elective surgical intervention for recurrent effusion or for pericardial biopsy. Three minor complications included one vasovagal reaction and two asymptomatic pneumothoraces. Percutaneous ultrasonically guided and fluoroscopically controlled placement of a pericardial catheter is safe and effective for treatment and diagnosis of pericardial effusions.
报告了25例心包积液患者接受25次超声引导下经皮心包引流术及1次心包穿刺术的结果。在超声引导下初次穿刺心包腔后，22例手术通过荧光透视法控制采用Seldinger技术扩张并置入5F至8.3F导管。临床指征为心包填塞的紧急治疗（n = 6）或大量心包积液（n = 14）的紧急治疗。其余6例手术用于对少量积液进行明确诊断。穿刺部位剑突下23例，胸骨旁左侧3例。抽出液体量为20至1710毫升（中位数：615毫升）。心包引流的中位持续时间为3天（范围小于1天至21天）。48%的患者获得明确诊断。4例患者随后因复发性积液或心包活检接受择期手术干预。3例轻微并发症包括1例血管迷走神经反应和2例无症状气胸。超声引导下经皮穿刺并荧光透视法控制心包导管置入对于心包积液的治疗和诊断是安全有效的。
