缩窄性心包炎的外科治疗

SURGICAL TREATMENT FOR CONSTRICTIVE PERICARDITIS

  • 摘要: 目的:对外科手术治疗缩窄性心包炎的效果进行回顾性分析。方法:行部分心包切除术患者52例(男性35例,女性17例).平均年龄32.2岁,病程1个月~22年。采用左前外侧切口45例,左前外侧+胸骨横断切口5例,胸骨正中切口2例。结果:本组无手术死亡,46例症状完全或基本消失,4例好转,2例无改善。结论:认为缩窄性心包炎一经明确诊断,应尽早手术,解除心脏的机械压迫。配合围手术期处理,达到最佳治疗效果。心包切除范围是影响手术疗效的主要因素,而选择何种手术切口对远期结果无显著影响。

     

    Abstract: Aim: To analyse the effcct of surgical treatment for constrictive pericarditis retrospectively. Methods: 52 patients (35 males, 17 females) with constrictive pericarditis underwent partial pericardectomy. The mean age was 32. 2 yearold and the interval varied from 1 month to 22 years. The approach included a left antero - lateral thoracotomy (45 pts. ), a left antero - lateral thoracotomy with transverse sternotomy (5 pts. ), and a median sternotomy (2 pts. ), ResultS: There was no operative motality. Chmplete remission in 4 6 patients, spoptomatic improvement in 4 and no improvement in 2.Conclusion: Once the diagnosis on constrictive pericarditis done, the patient should be operated on as gnn as possible. The pe-rioperative treatment is important. The extent of pericardectomy is the main factor on surgical results and the approach has no significant effect on long - term results.

     

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