Ikäheimo M J, Huikuri H V, Airaksinen K E, Korhonen U R, Linnaluoto M K, Tarkka M R, Takkunen J T
Department of Medicine, Oulu University Central Hospital, Finland.
Am Heart J. 1988 Jul;116(1 Pt 1):97-102. doi: 10.1016/0002-8703(88)90255-4.
To investigate the incidence and clinical significance of postoperative pericardial effusion (PE), the presence of PE was evaluated by echocardiography, 1 and 2 weeks postoperatively, in 50 patients after insertion of a valve prosthesis and in 100 patients after coronary bypass surgery (50 patients receiving a combination of aspirin and dipyridamole and 50 receiving warfarin). PE was found during either procedure in 77% of patients and was marked in 29%. Symptoms of postpericardiotomy syndrome (p less than 0.05), pericardial friction rub (p less than 0.01), atrial arrhythmias (p less than 0.05), cardiac enlargement (p less than 0.01), and pleural effusion (p less than 0.05) were detected more frequently in patients with PE than in those without PE. PE was not related to the type of antithrombotic therapy, the rate of coronary bypass graft occlusion, or the type of cardiac surgery. However, the use of the left internal mammary artery as a coronary bypass graft was associated with a slightly higher incidence of PE (p less than 0.05). One patient (0.7%) required surgical drainage of PE. It was concluded that PE is a common and benign finding after cardiac surgery and usually disappears without specific therapy.
为研究术后心包积液（PE）的发生率及临床意义，我们通过超声心动图对50例瓣膜置换术后患者及100例冠状动脉搭桥术后患者（其中50例接受阿司匹林与双嘧达莫联合治疗，50例接受华法林治疗）术后1周和2周时的PE情况进行了评估。在这两种手术过程中，77%的患者发现有PE，其中29%为明显积液。与无PE的患者相比，有PE的患者术后心包切开综合征症状（p<0.05）、心包摩擦音（p<0.01）、房性心律失常（p<0.05）、心脏扩大（p<0.01）及胸腔积液（p<0.05）的检出率更高。PE与抗血栓治疗类型、冠状动脉搭桥移植血管闭塞率或心脏手术类型无关。然而，使用左乳内动脉作为冠状动脉搭桥移植血管与PE的发生率略高相关（p<0.05）。1例患者（0.7%）需要对PE进行手术引流。研究得出结论，PE是心脏手术后常见的良性表现，通常无需特殊治疗即可消失。
