Komiya T, Kohchi K, Imai K, Shiraga K, Kohno S, Kanzaki Y
Department of Cardiovascular Surgery, Kurashiki Central Hospital, Okayama, Japan.
Nihon Kyobu Geka Gakkai Zasshi. 1995 Apr;43(4):446-51.
Of 156 patients who underwent cardiac or aortic surgery using cardiopulmonary bypass, postoperative pericardial effusion was detected in 89 patients (57%). They were divided into four groups according to the size of pericardial effusion: No effusion (group N, n = 66), small effusion (group S, n = 42), moderate effusion (group M, n = 22) and large effusion (group L, n = 25). In group L, 68% of patients had symptoms and 44% had complications such as subxiphoid drainage and constrictive pericarditis. Fewer patients with perioperative pleurotomy were found in group L than group N (p < 0.05). Postoperative anticoagulation did not affect the size of pericardial effusion. Postoperative amount of drainage were larger in groups, S, M, L than group N (p < 0.05, p < 0.05, p < 0.005). The CRP reelevation rate of each group was equal but the maximum CRP value was higher in group L than group N (p > 0.05). These results suggest that some relationship exists among postoperative drainage, inflammatory response and postoperative pericardial effusion. Since large pericardial effusion is often symptomatic and accompanied by various complications, earlier detection of pericardial effusion and appropriate treatment seems to be essential.
在156例接受体外循环心脏或主动脉手术的患者中，89例（57%）术后检测到心包积液。根据心包积液的大小将他们分为四组：无积液组（N组，n = 66）、少量积液组（S组，n = 42）、中等量积液组（M组，n = 22）和大量积液组（L组，n = 25）。在L组中，68%的患者有症状，44%的患者有诸如剑突下引流和缩窄性心包炎等并发症。L组中接受围手术期胸膜切开术的患者比N组少（p < 0.05）。术后抗凝不影响心包积液的大小。S组、M组、L组术后引流量比N组多（p < 0.05，p < 0.05，p < 0.005）。各组的CRP再次升高率相同，但L组的CRP最大值高于N组（p > 0.05）。这些结果表明术后引流、炎症反应和术后心包积液之间存在某种关系。由于大量心包积液常伴有症状并伴有各种并发症，早期检测心包积液并进行适当治疗似乎至关重要。
