Department of Anesthesiology, Beijing Chao-Yang Hospital, Capital Medical University, Beijing, China.
J Int Med Res. 2020 Aug;48(8):300060520945895. doi: 10.1177/0300060520945895.
Cardiac tamponade is a rare complication that occurs during hemihepatectomy. This particular complication has a high degree of mortality and morbidity. A 51-year-old woman was admitted to our hospital for surgical treatment of a malignant liver tumor. During surgery, she developed sudden hemodynamic instability and signs suggesting cardiac tamponade, which was confirmed via transthoracic echocardiogram. Cardiac compression and creation of a pericardial window resulted in immediate hemodynamic improvement. At completion of surgery, a repeated transthoracic echocardiogram showed no pericardial effusion. Early ultrasound-assisted diagnosis and treatment of cardiac tamponade are crucial. Although cardiac tamponade rarely occurs during hemihepatectomy, medics should be aware of this possibility to ensure prompt diagnosis. Our findings strongly support the use of early cardiac compression in cardiac arrest during surgery with echocardiography for prompt and accurate diagnosis of cardiac tamponade. Additionally, our findings will hopefully make anesthesiologists aware of the need to maintain a high index of suspicion for cardiac tamponade with sudden hypotension and a large reduction in differential pressure, and encourage early use of echocardiography and timely cardiac compression.
心脏压塞是半肝切除术中罕见的并发症。这种特殊的并发症具有很高的死亡率和发病率。一名 51 岁女性因恶性肝肿瘤接受手术治疗而入院。手术过程中，她突然出现血流动力学不稳定，并出现心脏压塞的迹象，经经胸超声心动图证实。心脏受压和心包开窗术导致立即血流动力学改善。手术完成时，重复经胸超声心动图显示无心包积液。早期超声辅助诊断和治疗心脏压塞至关重要。尽管心脏压塞在半肝切除术中很少发生，但医务人员应该意识到这种可能性，以确保及时诊断。我们的研究结果强烈支持在心脏骤停期间使用心脏超声进行早期心脏按压，以便及时准确地诊断心脏压塞。此外，我们的研究结果有望使麻醉师意识到，在出现突然低血压和压差大幅下降时，应高度怀疑心脏压塞，并鼓励早期使用超声心动图和及时进行心脏按压。
