Wu J, Liang S, Zhang Z
Tianjin Chest Hospital.
Zhonghua Zhong Liu Za Zhi. 1996 May;18(3):221-3.
Diagnosis and treatment of malignant pericardial effusion are difficult in clinical practice. This paper reports the feasibility and reliability of percutanous trans-catheter intervention for the diagnosis and treatment of malignant pericardial effusion. Under echocardiagraphic guidence, pericardial puncture was performed and a heamostasis sheath was placed in situ by Seldinger technique. Through the sheath multiple biopsies of the pericardium were taken for pathological examination. A pigtail catheter was inserted to drain off the effusion. According to pathological report suitable anti-cancer drugs were instilled into the pericardial cavity through indwelling catheter for 3-5 days. The catheter was withdrawn when fluid did not re-accumulate. Diagnosis was made in over 96.0% of the cases. Upon follow-up for 3-6 months, complete remission was seen in 96.0% of the treated patients. No significant complication was found in all patients. Percutaneous trans-catheter intervention is a useful approach for the diagnosis and treatment of malignant pericardial effusion.
恶性心包积液的诊断和治疗在临床实践中颇具难度。本文报告经皮导管介入诊断和治疗恶性心包积液的可行性和可靠性。在超声心动图引导下,进行心包穿刺,并采用Seldinger技术原位置入止血鞘。通过该鞘对心包进行多次活检以作病理检查。插入猪尾导管引流积液。根据病理报告,经留置导管向心包腔内注入合适的抗癌药物,持续3至5天。当液体不再积聚时拔出导管。超过96.0%的病例得以确诊。经3至6个月随访,96.0%的接受治疗患者实现完全缓解。所有患者均未发现明显并发症。经皮导管介入是诊断和治疗恶性心包积液的一种有效方法。