Wei Weifeng, Shen Panxiao, Liu Shaowei, Li Naijian, Zeng Yunxiang, Ma Lunchao, Wang Jinlin
Pulmonary and Critical Care Medicine, State Key Laboratory of Respiratory Disease, National Center for Respiratory Medicine, Guangzhou Institute of Respiratory Health, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China.
Department of Cardiothoracic Surgery, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China.
Front Med (Lausanne). 2024 Nov 15;11:1419750. doi: 10.3389/fmed.2024.1419750. eCollection 2024.
The primary objective of this study is to analyze the clinical manifestations, diagnostic procedures, and outcomes of patients with pathologically confirmed constrictive pericarditis who presented with bilateral pleural effusions. We aim to outline a stepwise diagnostic approach that could assist clinicians in identifying CP in similar cases.
In this study, we conducted a retrospective analysis of 19 cases of pathologically confirmed constrictive pericarditis. These patients were admitted to our hospital between January 2019 and December 2022 after pericardial stripping. The collected data included imaging findings, clinical manifestations, pleural effusion characteristics, postoperative pathology, and the diagnostic process.
In this study, the age of the 19 patients ranged from 25 to 74 years, with a median age of 59 years. All patients presented with bilateral pleural effusions, with or without pericardial lesions such as pericardial effusion or thickening. Pleural effusion biochemistry did not exhibit specific characteristics, and both etiology and pleural pathology were negative. Radiographic examinations, including cardiac ultrasound and chest CT, revealed signs of pericardial thickening and/or pericardial effusion or no abnormalities. Pericardial stripping was performed in all patients, and the postoperative pathology confirmed various degrees of thickened pericarditis, consistent with constrictive pericarditis. During a follow-up period of 6-18 months, most patients (17 out of 19) showed favorable recovery with no recurrence of bilateral pleural effusions.
This study emphasizes the importance of pleural effusion as a clinical sign of constrictive pericarditis and highlights that a stepwise diagnostic approach, guided by clinical presentation and imaging, can enhance its recognition, particularly in cases with bilateral pleural effusions.
本研究的主要目的是分析经病理证实为缩窄性心包炎且伴有双侧胸腔积液患者的临床表现、诊断方法及预后。我们旨在概述一种逐步诊断方法，以帮助临床医生在类似病例中识别缩窄性心包炎。
在本研究中，我们对19例经病理证实的缩窄性心包炎患者进行了回顾性分析。这些患者于2019年1月至2022年12月在我院接受心包剥脱术后入院。收集的数据包括影像学检查结果、临床表现、胸腔积液特征、术后病理及诊断过程。
本研究中，19例患者年龄在25至74岁之间，中位年龄为59岁。所有患者均出现双侧胸腔积液，伴有或不伴有心包积液或增厚等心包病变。胸腔积液生化检查未显示出特异性特征，病因及胸膜病理检查均为阴性。包括心脏超声和胸部CT在内的影像学检查显示有心包增厚和/或心包积液征象或无异常。所有患者均接受了心包剥脱术，术后病理证实为不同程度的增厚性心包炎，符合缩窄性心包炎。在6至18个月的随访期内，大多数患者（19例中的17例）恢复良好，双侧胸腔积液未复发。
本研究强调了胸腔积液作为缩窄性心包炎临床体征的重要性，并强调以临床表现和影像学为指导的逐步诊断方法可提高对其的认识，尤其是在双侧胸腔积液的病例中。
