Woll P J, Knight R K, Rubens R D
Imperial Cancer Research, Fund Clinical Oncology Unit, Guy's Hospital, London.
J R Soc Med. 1987 Aug;80(8):490-1. doi: 10.1177/014107688708000811.
Thirty-five patients with metastatic breast cancer and pericardial effusions are described. They were treated with specific endocrine or chemotherapy. Twenty-two (63%) had presented in cardiac tamponade and were rapidly relieved by pericardiocentesis. Eighteen (82%) of these required no further local treatment, 2 obtained relief from a second aspiration and 2 needed additional treatment (intrapericardial bleomycin instillation and surgical pleuropericardial window). The median survival was 13.2 months. No patient relapsed again in the pericardium, suggesting that their prognosis was that of the underlying disease. Cardiac tamponade should be considered in any breathless patient with malignancy. In breast cancer, periocardiocentesis is lifesaving and systemic treatment can usefully prolong life.
本文描述了35例转移性乳腺癌合并心包积液的患者。他们接受了特定的内分泌治疗或化疗。22例（63%）出现心脏压塞，通过心包穿刺术迅速缓解。其中18例（82%）无需进一步局部治疗，2例通过再次穿刺缓解，2例需要额外治疗（心包内注射博来霉素和手术胸膜心包开窗术）。中位生存期为13.2个月。没有患者心包再次复发，提示其预后取决于基础疾病。任何患有恶性肿瘤且呼吸困难的患者都应考虑心脏压塞。在乳腺癌中，心包穿刺术可挽救生命，全身治疗可有效延长生命。
