Kleiman J H, Motta J, London E, Pennell J P, Popp R L
Br Heart J. 1978 Feb;40(2):190-3. doi: 10.1136/hrt.40.2.190.
Echocardiography has greatly increased the accurate recognition of pericardial effusion. Echocardiograms were performed prospectively on the total group of 35 stable asymptomatic patients on chronic haemodialysis to determine the incidence of pericardial effusion. Effusions were shown in 11 per cent (4/35); only 6 per cent (2/35) were estimated as greater than 100 ml. For comparison, records were reviewed retrospectively from 41 haemodialysis patients referred during a 27-month period for echocardiographic assessment of suspected pericardial effusion. These 41 patients came from a total group of 108 patients treated with chronic dialysis over this interval. Of 41 examined, 21 (51%) or 21 of 108 (19%) of the population at risk had an effusion. Of 21 with echocardiographic effusions, 15 (71%), or 15 of 41 (37%) of those with clinically suspected effusion, had more than 100 ml fluid. Gross (greater than 100 ml) pericardial effusions are infrequent in stable, asymptomatic patients with end-stage renal disease. When clinical findings suggest pericardial disease, the echocardiographic demonstration of over 100 ml pericardial fluid is indicative of new effusion, rather than coincidental pre-existing effusion.
超声心动图极大地提高了对心包积液的准确识别能力。对35例稳定的无症状慢性血液透析患者进行了前瞻性超声心动图检查，以确定心包积液的发生率。结果显示11%（4/35）的患者存在积液；估计只有6%（2/35）的患者积液量超过100毫升。作为对照，回顾性查阅了27个月期间转诊进行超声心动图评估疑似心包积液的41例血液透析患者的记录。这41例患者来自同期接受慢性透析治疗的108例患者。在接受检查的41例患者中，有21例（51%）或108例中的21例（19%）有积液。在21例有超声心动图显示积液的患者中，15例（71%）或临床疑似积液患者中的15例（37%）积液量超过100毫升。在稳定的无症状终末期肾病患者中，大量（超过100毫升）心包积液并不常见。当临床检查提示心包疾病时，超声心动图显示心包积液超过100毫升提示为新出现的积液，而非偶然存在的既往积液。
