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1、中南大学学报(医学版)2011,36(1)http://xbyx.xysm.net74JCentSouthUniv(MedSci)心导管术所致心脏压塞沈向前,方臻飞,胡信群,刘启明,周滔,唐建军,周胜华,吕晓玲(中南大学湘雅二医院心内科,长沙410011)[摘要]目的:探讨心导管检查术及心脏介入术中发生心脏穿孔、心脏压塞的原因及紧急处理的方式和效果。方法:回顾性分析1986年1月至2009年12月在中南大学湘雅二医院心导管室接受诊断性心导管检查术或各种心脏介入术共23319例患者的资料。结果:在23319例各种心导管术中,共有22例(0.
2、094%)发生急性心脏压塞。其分布情况为:冠状动脉造影术1例,二尖瓣球囊扩张术9例,心导管检查术3例,先天性心脏病介入治疗2例,起搏器安置术2例,心房颤动射频消融术2例,冠心病介入治疗3例。11例与房间隔穿剌或经房间隔手术有关,2例与高压注射有关。17例发生在手术中,5例发生在术后2~14h。11例经心包穿刺引流抢救成功;11例经开胸减压并治疗原发心脏病,7例抢救成功,4例手术后仍然死亡。结论:心脏压塞是各种心导管术中的一种危及生命的严重并发症。提前防范、及早发现并做心包穿剌引流术是成功抢救病人的关键。[关键词]心导管术;心脏穿孔;心脏压塞
3、;心包穿剌术DOI:10.3969/j.issn.16727347.2011.01.012CardiacperforationandtamponadeinpercutaneouscardiacinterventionSHENXiangqian,FANGZhenfei,HUXinqun,LIUQiming,ZHOUTao,TANGJianjun,ZHOUShenghua,LXiaoling(DepartmentofCardiology,SecondXiangyaHospital,CentralSouthUniversity,Changsha4
4、10011,China)Abstract:ObjectiveToexplorethecauseofcardiacperforationandtamponadeduringcardiaccatheterizationandinterventionandtoevaluatetheeffectivenessoftheemergencytreatmentfortamponadeinourhospital.MethodsTheclinicaldatafrom23319patientswhoreceiveddiagnosticcatheteriza
5、tionortherapeuticprocedureswereanalyzedretrospectively.ResultsCardiacperforationandcardiactamponadewereobservedin22ofthe23319patientsduringcatheterprocedures.Itincludes1incoronaryarteryangiography,9inpercutaneousballoonmitralvalvuloplasty,3indiagnosis,2incongenitalheartdis
6、easeintervention,2inpacemakerimplantation,2inatrialfibrillationablationandtheother3incoronaryrevascularization.Theoccurrenceofcardiacperforationin11patientswasrelatedtopunctureoftheinteratrialseptumand/ortheprocedureintheleftatrialprocedureand2wererelatedtohighpressureinjec
7、tion.Seventeenpatientswerefoundcardiactamponadeintheprocessofcatheterization,and5werefoundat2-14hafteroperation.Pericardiocentesisandpericardialcatheterdrainagewereperformedin20patientsand11ofthemsucceeded.Amongtheother11patients,7weresuccessfullysavedbythoracotomyand4died.Co
8、nclusionCardiactam收稿日期(Dateofreception)2010-03-17作者简介(Biography)
