Department of Anatomical Sciences, St George's University, School of Medicine, Grenada, West Indies.
Clin Anat. 2012 Oct;25(7):872-81. doi: 10.1002/ca.22032. Epub 2012 Jan 31.
The safe and successful performance of pericardiocentesis demands a working and specific knowledge of anatomy. Misunderstanding of anatomy may result in failure or serious complications. This review attempts to aid understanding of the anatomical framework, pitfalls, and complications of pericardiocentesis. Pericardiocentesis is carried out for aspiration of blood from the pericardial cavity in cases of cardiac tamponade and symptomatic pericardial effusion. In addition, this technique may be used for the diagnosis of neoplastic effusions, purulent pericarditis, and introduction of cytotoxic agents into the pericardial space. Most complications of the procedure are due to the needle penetrating the heart and surrounding structures such a coronary arteries, lungs, stomach, colon, and liver. These complications, if severe, may result in pneumothorax, hemothorax, arrhythmias, infections or arterial bleeding. Therefore, the more fluid or blood there is between the myocardium and pericardium--within the pericardial cavity--the less chance of complications. With a thorough knowledge of the complications, regional anatomy and rationale of the technique, and adequate experience, a pericardiocentesis can be carried out safely and successfully.
心包穿刺术的安全和成功实施需要对解剖学有一定的了解。对解剖学的误解可能导致手术失败或出现严重并发症。本文旨在帮助理解心包穿刺术的解剖结构、陷阱和并发症。心包穿刺术用于心脏压塞和有症状的心包积液患者的心包腔抽吸血液。此外，该技术可用于诊断肿瘤性积液、化脓性心包炎和将细胞毒性药物引入心包腔。该操作的大多数并发症是由于针穿透心脏和周围结构（如冠状动脉、肺、胃、结肠和肝脏）引起的。这些并发症如果严重，可能导致气胸、血胸、心律失常、感染或动脉出血。因此，心肌和心包之间的积液或血液越多——心包腔内的积液或血液越多——并发症的机会就越小。如果对并发症、局部解剖学和技术原理有透彻的了解，并具备足够的经验，心包穿刺术就可以安全、成功地进行。
