Dybowska Małgorzata, Szturmowicz Monika, Błasińska Katarzyna, Gątarek Juliusz, Augustynowicz-Kopeć Ewa, Langfort Renata, Kuca Paweł, Tomkowski Witold
I Department of Lung Diseases, National Tuberculosis and Lung Diseases Research Institute, 01-138 Warsaw, Poland.
Department of Radiology, National Tuberculosis and Lung Diseases Research Institute, 01-138 Warsaw, Poland.
Diagnostics (Basel). 2022 Jun 13;12(6):1453. doi: 10.3390/diagnostics12061453.
Large pericardial effusion (LPE) is associated with high mortality. In patients with cardiac tamponade or with suspected bacterial etiology of pericardial effusion, urgent pericardial decompression is necessary.
The aim of the present retrospective study was to assess the short-term results of pericardial decompression combined with prolonged drainage in LPE.
This study included consecutive patients with LPE who had been treated with pericardial fluid drainage between 2007 and 2017 in the National Tuberculosis and Lung Diseases Research Institute.
Echocardiographic examination was used to confirm LPE and the signs of cardiac tamponade. Pericardiocentesis or surgical decompression were combined with pericardial fluid (PF) drainage. Short-term effectiveness of therapy was defined as less than 5 mm of fluid behind the left ventricular posterior wall in echocardiography.
The analysis included 74 patients treated with pericardial fluid drainage (33 female and 41 male), mean age 58 years, who underwent pericardial decompression. Out of 74 patients, 26 presented with cardiac tamponade symptoms. Pericardiocentesis was performed in 18 patients and pericardiotomy in 56 patients. Median PF drainage duration was 13 days. In 17 out of 25 patients with neoplastic PF, intrapericardial cisplatin therapy was implemented. In 4 out of 49 patients with non-malignant PF, purulent pericarditis was recognized and intrapericardial fibrinolysis was used. Short-term effectiveness of the therapy was obtained in all of patients. Non-infective complications were noted in 16% of patients and infective ones in 10%.
Pericardial decompression combined with prolonged PF drainage was safe and efficient method of LPE treatment.
大量心包积液（LPE）与高死亡率相关。对于心脏压塞患者或心包积液疑似细菌病因的患者，紧急心包减压是必要的。
本回顾性研究的目的是评估心包减压联合长时间引流治疗LPE的短期效果。
本研究纳入了2007年至2017年期间在国家结核病和肺部疾病研究所接受心包积液引流治疗的连续性LPE患者。
采用超声心动图检查来确认LPE和心脏压塞的体征。心包穿刺或手术减压联合心包积液（PF）引流。治疗的短期有效性定义为超声心动图检查中左心室后壁后方的液性暗区小于5mm。
分析包括74例接受心包积液引流治疗的患者（33例女性和41例男性），平均年龄58岁，均接受了心包减压。74例患者中，26例出现心脏压塞症状。18例患者进行了心包穿刺，56例患者进行了心包切开术。PF引流的中位持续时间为13天。25例肿瘤性PF患者中有17例实施了心包内顺铂治疗。49例非恶性PF患者中有4例被诊断为化脓性心包炎并采用了心包内纤维蛋白溶解治疗。所有患者均获得了治疗的短期有效性。16%的患者出现非感染性并发症，10%的患者出现感染性并发症。
心包减压联合长时间PF引流是治疗LPE的安全有效的方法。
