【摘要】 目的探讨缩窄性心包炎的围手术期处理方法以及要点。方法统计分析1982年5月至2005年12月协和医院心脏外科手术治疗缩窄性心包炎患者126例,男88例,女38例,平均年龄(31.2±16.1)岁。术前大多有水肿、呼吸困难、胸痛等症状。X线检查有93例提示心包钙化灶,钙化率73.81%。术前心功能NYHA分级Ⅰ级7例、Ⅱ级21例、Ⅲ级98例,术前中心静脉压为(22.13±8.24)kPa,左心射血分数(EF)值为(34.3±17.4)%。其中47例行全心包切除术,79例行部分心包切除术。结果123例术后心功能均明显改善,2例术后早期死于低心功能排出量,死亡率1.6%,1例手术后出现昏迷,于术后第10天自动出院。中心静脉压下降为(9.33±4.36)kPa。术后超声心动图示左心射血分数升至(51.8±12.1)%,心功能Ⅰ级47例、Ⅱ级76例。术后随访,2例行部分心包切除术患者分别于术后第3年和第5年死于心力衰竭。结论早期处理、彻底剥离、围手术期慎重处理对提高缩窄性心包炎手术成功率具有重要意义。更多还原

【Abstract】 Objective To explore peri-surgical treatment of 126 cases of constrictive pericarditis.Methods From May 1982 to Dec.2005,126 patients with constrictive pericarditis,88 males and 38 females with a mean age of(31.2±16.1) years,underwent heart surgery.Before operation,edema,dyspnea,fatigue and chest pain were the most common manifestations.X-ray examination revealed that 93 patients(73.81%) had calcification.Preoperatively,there were 7 cases of NYHA class Ⅰ,21 cases of class Ⅱ,98 cases of class Ⅲ.Before operation,central venous pressure(CVP) was(22.13±8.24) kPa.Among 126 patients,47 were subjected to total pericardiectomy and 79 to partial pericardiectomy.Results 123 patients achieved NYHA class Ⅰ and Ⅱ postoperatively.Two patients(1.6%) died on the 7th day after operation,and 1 patient suffered from coma after operation and left hospital automatically 10 days later.Conclusion Early treatment,complete dissection and perioperative management are of importance in increasing the successful rate of surgical operation for constrictive pericarditis.更多还原