Uemura S, Kagoshima T, Hashimoto T, Sakaguchi Y, Doi N, Nakajima T, Tabuse H, Miyamoto S, Dohi K
First Department of Internal Medicine, Nara Medical University, Japan.
Jpn Circ J. 1995 Jan;59(1):55-9. doi: 10.1253/jcj.59.55.
We describe the complications of pericardiocentesis and their management in an 18 year-old man. This patient was admitted because of dyspnea and was found on echocardiogram to have cardiac tamponade with coexisting left ventricular dysfunction. He developed acute left ventricular failure with severe pulmonary edema immediately after pericardiocentesis. This complication may have been caused by an abrupt increase in venous return to the failing left ventricle following the release of the pericardial compression. Therefore, pericardial fluid must be drained with caution in pericardiocentesis, especially in cardiac tamponade patients with left ventricular dysfunction, and hemodynamics should be monitored both during and after this procedure.
我们描述了一名18岁男性心包穿刺术的并发症及其处理情况。该患者因呼吸困难入院，经超声心动图检查发现有心包填塞并伴有左心室功能不全。心包穿刺术后，他立即出现急性左心室衰竭并伴有严重肺水肿。这种并发症可能是由于心包压迫解除后，衰竭的左心室静脉回心血量突然增加所致。因此，心包穿刺术引流心包积液时必须谨慎，尤其是对于伴有左心室功能不全的心包填塞患者，在此操作过程中和操作后都应监测血流动力学。
