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甲状腺功能减退患者出现大量心包积液时的心包减压综合征：一例病例报告及相关文献综述

Pericardial decompression syndrome in a patient with hypothyroidism presenting as massive pericardial effusion: a case report and review of related literature.

作者信息

Lim Aveline Sue Ann Lim, Paz-Pacheco Elizabeth, Reyes Michael, Punzalan Felix

机构信息

Department of Medicine, Section of Endocrinology, Diabetes and Metabolism, UP-Philippine General Hospital, Manila, Philippines.

出版信息

BMJ Case Rep. 2011 Oct 4;2011:bcr0420114117. doi: 10.1136/bcr.04.2011.4117.

DOI:10.1136/bcr.04.2011.4117
PMID:22679149
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC3189646/
Abstract

The authors present a case of a 44-year-old female with unrecognised hypothyroidism consulting for heart failure symptoms. Echocardiogram revealed massive pericardial effusion with tamponade physiology, attributed to primary hypothyroidism from a previous thyroidectomy. Levothyroxine was started at a dose of 0.7 ug/kg/day followed by subxiphoid pericardiostomy. 9 h postpericardiostomy however, hypotension developed and despite hydration and inotropic support, patient succumbed to cardiogenic shock on the 14th hospital day.

摘要

作者报告了一例44岁女性病例，该患者因心力衰竭症状就诊，此前未被诊断出甲状腺功能减退。超声心动图显示大量心包积液并伴有心脏压塞生理表现，病因是既往甲状腺切除术后导致的原发性甲状腺功能减退。开始给予左甲状腺素，剂量为0.7微克/千克/天，随后进行剑突下心包造口术。然而，心包造口术后9小时出现低血压，尽管进行了补液和使用正性肌力药物支持，但患者在住院第14天死于心源性休克。

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本文引用的文献

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Hypothyroidism presenting with recurrent pericardial tamponade.以反复心包填塞为表现的甲状腺功能减退症。
BMJ Case Rep. 2009;2009. doi: 10.1136/bcr.03.2009.1674. Epub 2009 Dec 1.
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Post pericardiocentesis low cardiac output syndrome in a patient with malignant thymoma.恶性胸腺瘤患者心包穿刺术后低心排血量综合征
BMJ Case Rep. 2009;2009. doi: 10.1136/bcr.12.2008.1364. Epub 2009 May 21.
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Hypothyroid cardiac tamponade: clinical features, electrocardiography, pericardial fluid and management.甲状腺功能减退性心脏压塞：临床特征、心电图、心包积液和处理。
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Pericardial decompression syndrome: a term for a well-defined but rather underreported complication of pericardial drainage.心包减压综合征：一个用于描述心包引流中一种明确但报道较少的并发症的术语。
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Cardiac tamponade in Hashimoto's disease.桥本氏病并发心脏压塞
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Transient biventricular dysfunction following pericardiocentesis.
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