心包穿刺术联合顺铂治疗恶性心包积液并心脏压塞。
Pericardiocentesis with cisplatin for malignant pericardial effusion and tamponade.
机构信息
Department of Surgery, Social Insurance Yokohama Central Hospital, 268 Yamashita-cho, Naka-ku, Yokohama 231-8553, Japan.
出版信息
World J Gastroenterol. 2010 Feb 14;16(6):740-4. doi: 10.3748/wjg.v16.i6.740.
AIM
To evaluate the role and outcome of pericardiocentesis with intrapericardial cisplatin instillation for malignant pericardial effusion resulting from esophageal cancer.
METHODS
We retrospectively studied 7 patients who underwent pericardiocentesis with intrapericardial cisplatin instillation for malignant pericardial effusion resulting from esophageal cancer. After pericardiocentesis, we performed catheterization of the pericardial space under ultrasonogram guidance. Malignant etiology of the pericardial fluid was confirmed by cytological examination. Subsequently, cisplatin (10 mg in 20 mL normal saline) was instilled into the pericardial space.
RESULTS
The mean total volume of the aspirated effusion fluid was 782 +/- 264 mL (range, 400-1200 mL). The drainage catheter was successfully removed in all patients, and the mean duration of pericardial drainage was 7.7 +/- 2.7 d (range, 5-13 d). No fluid reaccumulation was observed. Mean survival time was 120 +/- 71 d (range, 68-268 d).
CONCLUSION
Pericardiocentesis along with catheter drainage appears to be a safe and effective for pericardial malignant effusion and tamponade, and cisplatin instillation prevents recurrence.
目的
评估心包穿刺并腔内顺铂灌注治疗食管癌所致恶性心包积液的作用和疗效。
方法
我们回顾性研究了 7 例行心包穿刺并腔内顺铂灌注治疗食管癌所致恶性心包积液的患者。心包穿刺后，在超声引导下进行心包腔置管。心包液的恶性病因通过细胞学检查得到确认。随后，将顺铂（10mg 溶于 20ml 生理盐水）注入心包腔。
结果
平均吸出的胸腔积液总量为 782 ± 264ml（范围，400-1200ml）。所有患者均成功拔除引流管，心包引流的平均持续时间为 7.7 ± 2.7d（范围，5-13d）。未见积液再积聚。平均生存时间为 120 ± 71d（范围，68-268d）。
结论
心包穿刺联合导管引流似乎是治疗恶性心包积液和填塞的一种安全有效的方法，顺铂灌注可防止复发。
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