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[心脏压塞:使用中心静脉置管常用套件进行紧急心包穿刺术]

[Cardiac tamponade: emergency pericardiocentesis using a common set for central venous catheterization].

作者信息

Minutiello L

机构信息

Ospedale di Urbino, Regione Marche, Azienda Sanitaria n. 2.

出版信息

Minerva Cardioangiol. 1996 Apr;44(4):209-20.

PMID:8767602
Abstract

Cardiac tamponade is compression of the heart due to an anomalous amount of fluid in the pericardium. The increased intrapericardial pressure prevents the heart from expanding adequately during diastole. As a consequence, stroke volume, blood pressure and cardiac output decrease. Cardiac tamponade is a cardiac emergency. If the fluid in the pericardium is not very quickly removed, the patient will die from cardiogenic shock. It is possible to perform successful pericardiocentesis (cardiac surgery division for pericardiotomy is not present in every hospital) with a common set for catheterisation of the vena cava using the Seldinger technique. This emergency treatment is being used more and more diffuse among cardiologists for its effectiveness, but rigorous knowledge of anatomic structures and good experience in management of sets used for catheterisation of central veins are necessary, to avoid possible grave complications. We report 3 cases of cardiac tamponade, admitted to the CCU for cardiogenic shock, successful by treated by pericardiocentesis.

摘要

心脏压塞是指由于心包腔内异常积液导致心脏受压。心包腔内压力升高会阻止心脏在舒张期充分扩张。结果,每搏输出量、血压和心输出量均下降。心脏压塞是一种心脏急症。如果心包内的液体不能很快清除,患者将死于心源性休克。使用Seldinger技术,采用普通的腔静脉置管套件就可以成功地进行心包穿刺术(并非每家医院都有心脏外科进行心包切开术)。这种急救治疗因其有效性在心脏病专家中越来越广泛地应用,但必须对解剖结构有严格的了解,并在中心静脉置管套件的操作方面有丰富经验,以避免可能的严重并发症。我们报告3例因心源性休克入住冠心病监护病房的心脏压塞患者,经心包穿刺术治疗成功。

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