Desaulniers D, Gervais N, Rouleau J
Can J Surg. 1981 May;24(3):265-8.
The postpericardiotomy syndrome occurs in 10% to 40% of patients who undergo open-heart surgery. Its frequency is reportedly decreased when pericardial drainage is used. To challenge this, 50 consecutive patients (1 was disqualified) were randomly assigned to two groups: one in which only the anterior mediastinum was drained (group 1) and the other in which the anterior mediastinum and posterior pericardium were drained (group 2). The surgical procedures performed were: coronary artery bypass grafting in 14 patients, valve surgery in 23 and repair of congenital defects in 12. The two groups were similar with respect to age and the volume of blood drained. Significant differences were found only for the duration of bypass and volume of blood given. At 7 to 10 days there were no differences in the frequency of fever, thoracic pain or presence of arthralgia. Findings were similar in both groups for leukocyte count, sedimentation rate, serum lactic dehydrogenase value and for the frequency of positive blood, urine and sputum cultures. Six patients (three in each group) had a postpericardiotomy syndrome that required steroid treatment and prolonged hospitalization for 10 more days. However, none had postpericardiotomy syndrome complicating coronary artery bypass surgery. None of the patients had cardiac tamponade. This study demonstrates that pericardial drainage has no effect on the frequency of postpericardiotomy syndrome and appears to be unnecessary after open-heart surgery.
心脏切开术后综合征发生于10%至40%接受心脏直视手术的患者中。据报道，使用心包引流时其发生率会降低。为验证这一点，连续50例患者（1例不合格）被随机分为两组：一组仅引流前纵隔（第1组），另一组引流前纵隔和心包后间隙（第2组）。所施行的外科手术包括：14例冠状动脉搭桥术、23例瓣膜手术和12例先天性缺陷修复术。两组在年龄和引流量方面相似。仅在体外循环时间和输血量方面发现显著差异。在7至10天时，发热、胸痛或关节痛的发生率无差异。两组在白细胞计数、血沉、血清乳酸脱氢酶值以及血、尿和痰培养阳性率方面的结果相似。6例患者（每组3例）发生了心脏切开术后综合征，需要类固醇治疗并延长住院10天。然而，无人因心脏切开术后综合征而使冠状动脉搭桥手术复杂化。无一例患者发生心脏压塞。本研究表明，心包引流对心脏切开术后综合征的发生率无影响，心脏直视手术后似乎无需进行心包引流。
