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目的:分析心脏介入手术并发心脏压塞的原因表现及治疗,为临床早期诊治提供依据。方法:3228例心脏介入性手术中共发生8例心脏压塞的病例,分析其可能的原因、临床表现以及其治疗结果。结果:其中3例与经皮冠状动脉内成形术有关,3例与经皮二尖瓣球囊成形术有关,2例与导管标测和射频消融术有关。心脏压塞的主要原因包括冠状动脉穿孔、心房穿孔、冠状静脉窦破裂以及左心室穿孔。6例经立即心包穿刺抽液150～500ml病情稳定,2例因为出血量大进行了外科手术,其中1例因为心脏穿孔无法缝合裂口死亡。结论:心脏压塞是心脏介入性手术的严重并发症,积极预防、早期发现、及时诊断和果断处理十分重要。
Objective: To analyze the causes and treatment of cardiac tamponade complicated with cardiac interventional surgery and provide the basis for early clinical diagnosis and treatment. Methods: A total of 8 cases of cardiac tamponade occurred in 3228 cases of cardiac interventional surgery. The possible causes, clinical manifestations and treatment outcome were analyzed. Results: Three of them were related to percutaneous transluminal coronary angioplasty, three were related to percutaneous balloon mitral valvuloplasty, and two were related to catheterization and radiofrequency catheter ablation. The main causes of cardiac tamponade include coronary perforation, atrial perforation, coronary sinus rupture, and left ventricular perforation. 6 cases of immediate pericardial aspiration 150 ~ 500ml stable condition, 2 cases because of the large amount of bleeding surgery, of which 1 case of heart puncture can not be sutured to death. Conclusion: TCD is a serious complication of cardiac interventional surgery. It is very important to actively prevent, detect, diagnose and decisive treatment timely.