Stevenson L W, Child J S, Laks H, Kern L
Am J Cardiol. 1984 Oct 1;54(7):848-51. doi: 10.1016/s0002-9149(84)80219-2.
Echocardiography (echo) is frequently performed postoperatively to evaluate patients suspected of having cardiac tamponade or pericarditis. The overall incidence and significance of echocardiographic pericardial effusions (PE) early after cardiac surgery are unknown. Therefore, M-mode and 2-dimensional (2-D) echo were used to study 39 stable patients 4 to 10 days after cardiac surgery. Twenty-two patients (56%) had unequivocal moderate-to-large PEs. PEs were identified on serial chest x-rays in only 6 patients. PEs were significantly more common after heavy postoperative bleeding, and occurred in 16 of 19 patients with more than 500 ml of total chest tube output; only 6 of 20 patients with chest tube output less than 500 ml had PE. There was no correlation of PE by echo with pericardial friction rubs, chest pain or atrial arrhythmias. Elevated erythrocyte sedimentation rate did not correlate with PE by echo or clinical pericarditis. In 1 of 22 patients with PE, tamponade developed, and the patient required reoperation on day 5; the other 21 were discharged without related therapy. Thus, early postoperative PEs are common and related to postoperative bleeding. Because they do not correlate with symptoms of pericarditis and rarely lead to tamponade, their identification is usually of limited clinical significance.
心脏超声检查（超声心动图）常在术后进行，以评估疑似患有心脏压塞或心包炎的患者。心脏手术后早期超声心动图检查发现心包积液（PE）的总体发生率及意义尚不清楚。因此，采用M型和二维（2-D）超声心动图对39例心脏手术后4至10天病情稳定的患者进行了研究。22例患者（56%）有明确的中至大量心包积液。仅6例患者在系列胸部X线检查中发现心包积液。术后大量出血后心包积液明显更常见，在19例胸腔引流管总引流量超过500 ml的患者中有16例出现心包积液；胸腔引流管引流量少于500 ml的20例患者中只有6例有心包积液。超声心动图检查发现的心包积液与心包摩擦音、胸痛或房性心律失常无关。红细胞沉降率升高与超声心动图检查发现的心包积液或临床心包炎无关。22例心包积液患者中有1例发生心脏压塞，该患者在第5天需要再次手术；其他21例未经相关治疗即出院。因此，术后早期心包积液很常见，且与术后出血有关。由于它们与心包炎症状无关，很少导致心脏压塞，其发现通常临床意义有限。
