Department of Cardiac Surgery, Niguarda Ca' Granda Hospital, Milan, Italy.
Ann Thorac Surg. 2013 May;95(5):1818-26. doi: 10.1016/j.athoracsur.2012.11.020. Epub 2013 Apr 6.
Postsurgical intrapericardial adhesions are still considered an unavoidable consequence of cardiothoracic operations. They increase the technical difficulty and the risk of reoperations. The pathogenesis of postsurgical adhesions is a multistep process, and the main key players are (1) loss of mesothelial cells, (2) accumulation of fibrin in areas devoid of mesothelial cells, (3) loss of normal pericardial fibrinolysis, and (4) local inflammation. Today, very promising methods to reduce adhesions are available for clinical use. This report reviews the process of formation of adhesions and the methods to prevent them, classified according to the mechanism of action.
术后心包内粘连仍然被认为是心胸手术不可避免的后果。它们增加了手术的难度和再次手术的风险。术后粘连的发病机制是一个多步骤的过程，主要关键因素有：(1) 间皮细胞的丢失，(2) 无间皮细胞区域纤维蛋白的积累，(3) 正常的心包纤维蛋白溶解功能丧失，和 (4) 局部炎症。目前，有许多很有前途的减少粘连的方法可用于临床。本报告根据作用机制对粘连形成过程和预防方法进行了综述。
