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目的探讨经皮心包穿刺置管持续引流心包积液的疗效及安全性。方法回顾太和县人民医院2002年7月-2010年10月收治的87例心包积液患者,其中36例中等量和大量心包积液的患者,采用经皮心包穿刺置管国产规格为5Fr216cm一次性使用中心静脉导管持续引流。患者经CT或超声诊断和定位后,在病房床边心电监护下,患者取半卧位,选择剑突下或胸骨旁或心尖部为穿刺点,常规消毒、铺巾,2%利多卡因局麻,采用Seldinger技术穿刺心包,置单腔或双腔中心静脉导管行心包持续引流及通过置入导管于心包腔内引流或给药或冲洗。结果 36例患者均于病房床边置管成功,留置时间平均8d(5～16d),均无组织脏器损伤及感染。2例发生导管堵塞,经肝素生理盐水冲洗后再通。结论经皮心包穿刺置管持续引流是安全、简捷、有效的诊断和治疗心包积液方法。
Objective To investigate the efficacy and safety of percutaneous pericardiocentesis for continuous drainage of pericardial effusion. Methods Review of Taihe County People’s Hospital in July 2002 - October 2010 were treated 87 cases of patients with pericardial effusion, 36 cases of moderate and large amounts of pericardial effusion percutaneous pericardial catheterization of domestic specifications for the 5Fr216cm once Use central venous catheters for continuous drainage. Patients with CT or ultrasound diagnosis and positioning, the patient bedside ECG monitoring, the patient take the semi-recumbent position, select the xiphoid or parasternal or apical puncture point, conventional disinfection, shop towels, 2% lidocaine Local anesthesia, the use of Seldinger puncture the pericardium, single or double-lumen central venous catheter for perinuclear continuous drainage and catheterization through the pericardial drainage or administration or irrigation. Results All the 36 patients were successfully placed at the bed side of the ward, and the average retention time was 8 days (5 ~ 16 days). No organ injury and infection were found. 2 cases of catheter blockage, rinsed with heparin saline and then pass. Conclusion Percutaneous pericardiocentesis is a safe, simple and effective method for the diagnosis and treatment of pericardial effusion.