Cantó A, Guijarro R, Arnau A, Fernández-Centeno A, Císcar M A, Galbis J, García-Vilanova A
Thoracic Surgery Unit, Valencia University General Hospital, Spain.
Thorax. 1993 Nov;48(11):1178-80. doi: 10.1136/thx.48.11.1178.
The cause of cardiac tamponade is only established in 50% of cases. This problem is most commonly treated by pericardiocentesis alone, pericardiotomy being reserved for cases of recurrence and pericardiectomy for those patients presenting with constrictive pericarditis. A series of 16 patients treated with pericardial fenestration via a thoracoscope is presented. Pericardial and pleural biopsies were performed, together with cytological and biochemical analysis of the pericardial and pleural fluid where present. This procedure established the aetiology of effusion in all cases. In malignant pericardial effusion bleomycin was used for pericardial sclerosis. This resulted in fewer recurrences than in those patients where sclerosis was not attempted (12.5% v 60%).
仅50%的病例能明确心脏压塞的病因。这个问题最常见的治疗方法是单纯心包穿刺术，心包切开术用于复发病例，心包切除术用于患有缩窄性心包炎的患者。本文介绍了一组16例通过胸腔镜进行心包开窗术治疗的患者。进行了心包和胸膜活检，以及心包和胸膜液（如有）的细胞学和生化分析。该手术在所有病例中都确定了积液的病因。在恶性心包积液中，使用博来霉素进行心包硬化治疗。与未尝试硬化治疗的患者相比，复发率更低（12.5%对60%）。
