Cummings R G, Wesly R L, Adams D H, Lowe J E
Ann Thorac Surg. 1984 Jun;37(6):511-8. doi: 10.1016/s0003-4975(10)61146-0.
Cardiac tamponade most commonly results from accumulation of blood or other fluids within the pericardial sac. However, there is a growing body of clinical evidence showing that pneumopericardium can lead to cardiac tamponade in a large number of patients. Including those in the present report, a total of 252 patients with pneumopericardium are available for review. Interestingly, cardiac tamponade developed in 94 patients, or 37% of this group, because of air within the pericardial space. Pneumopericardium resulting in tamponade most frequently occurs in trauma patients or in newborn infants requiring positive pressure ventilation. This syndrome can be recognized promptly because of its characteristic physical findings and radiographic features. Although air tamponade can be treated effectively by either needle aspiration or insertion of a pericardial tube, the development of a pneumopericardium is a bad prognostic sign. Out of the 221 patients reported in the literature whose outcome is known, 127 (57%) died. In the group with a tension pneumopericardium, the mortality was 56% (53 out of 94 patients). Even without the development of tension, however, pneumopericardium was associated with a 58% mortality (74 out of 127 patients) due to other underlying disease processes.
心脏压塞最常见的原因是心包腔内血液或其他液体的积聚。然而，越来越多的临床证据表明，大量患者的气胸可导致心脏压塞。包括本报告中的患者在内，共有252例气胸患者可供回顾。有趣的是，94例患者（占该组的37%）因心包腔内有空气而发生了心脏压塞。导致心脏压塞的气胸最常发生在创伤患者或需要正压通气的新生儿中。由于其特征性的体格检查结果和影像学特征，该综合征可被迅速识别。虽然通过针吸或插入心包管可以有效治疗空气栓塞，但气胸的发生是一个不良的预后指标。在文献报道的221例已知结局的患者中，127例（57%）死亡。在张力性气胸组中，死亡率为56%（94例患者中有53例）。然而，即使没有发展为张力性气胸，由于其他潜在的疾病过程，气胸的死亡率也为58%（127例患者中有74例）。
