Doi S A, Azman W, Leong K W, Bosco J
Department of Medicine, University of Malaya, University Hospital, Kuala Lumpur, Malaysia.
Ann Acad Med Singap. 1995 May;24(3):459-61.
A typical case of chronic pericardial effusion resulting in cardiac tamponade is presented. A pericardiocentesis was done for diagnosis and drainage, followed by a pleuro-pericardial window as definitive therapy. The minimal cumulative dose expected to produce pericardial disease is about 4000 rads, and the disease usually manifests within 12 months of such radiation exposure, as in this patient. It is concluded that for symptomatic pericardial effusions, available evidence justifies a subtotal pericardiectomy, a window procedure being reserved to tide over ill patients as in this patient. No strong evidence exists for the efficacy of steroid therapy; such therapy is reserved for asymptomatic mild effusions, which may also resolve spontaneously.
本文介绍了一例典型的慢性心包积液导致心脏压塞的病例。为进行诊断和引流进行了心包穿刺术，随后进行胸膜心包开窗术作为确定性治疗。预计产生心包疾病的最小累积剂量约为4000拉德，并且该疾病通常在这种辐射暴露后的12个月内出现，如该患者所示。结论是，对于有症状的心包积液，现有证据支持进行心包次全切除术，而开窗手术则像该患者一样用于帮助病情严重的患者度过难关。对于类固醇治疗的疗效，尚无有力证据；这种治疗仅用于无症状的轻度积液，这类积液也可能自行消退。
