摘要
目的探讨外科方法治疗缩窄性心包炎的效果。方法对62例缩窄性心包炎患者在全麻插管下进行胸前正中切口劈骨入路心包剥离术,均选择胸骨正中作为切口,从粘连最轻的部位入手,切除范围为两侧达膈神经,左、右心室面,上至大血管根部、下至膈面。结果心包检查发现化脓性4例,慢性炎症伴纤维组织增生12例,结核性46例,术中无死亡病例,1年随访无并发症发生。结论在进行手术时应先左后右,彻底切除心包,做好术前术后处理,预防术后的低心排出量综合征,加快恢复速度。
Objective To explore the effect of surgical treatment of constrictive pericarditis. Methods Six- ty-two patients underwent perieardiolysis under the condition of general anesthesia and endotracheal intubation starting with lightest parts of adhesion. The operation was performed through median sternotomy incision. The resection range was that two sides were phrenic nerve and surface of left and right ventricles, the upper border was the root of large vessels and the inferior border was diaphragmatic surface. Results Detection of pericardium showed purulent pericar- ditis in 4 patients, chronic inflammation with fibrous tissue proliferation in 12 patients, tuberculous pericarditis in 46 patients. No patient died in our groups and one years of follow-up without complication. Conclusion The pericardiec- tomy shotdd be operated from the left side of heart to the right side, and from the effluent way to the influent way. Careful perioperative management is also necessary. These measures will play important roles for prevention of low cardiac output syndrome and accelerate the speed of recovery.
出处
《中国临床新医学》
2012年第10期962-964,共3页
CHINESE JOURNAL OF NEW CLINICAL MEDICINE
关键词
缩窄性心包炎
外科治疗
分析
Constrictive pericarditis
Surgical treatment
Analysis
