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|本期目录/Table of Contents|

心包腔容积—压力关系的临床研究(PDF)

《心脏杂志》[ISSN:1009-7236/CN:61-1268/R]

期数:
1999年第4期
页码:
232-234
栏目:
论著
出版日期:
1999-07-01

文章信息/Info

Title:
The study of pericardial volume-pressure relationship in patients with pericardial effusion
作者:
寿锡凌　陈新义　刘新宏　王军奎　吉海呜　于 丽
陕西省人民医院心内科,西安 710068
Author(s):
Shou Xiling; Chen Xinyi; Liu Xinhong ; Wang Junkui;  Ji Haiming ;  Yu Li
Department of Cardiology, Shaanxi Provincial People′s Hospital,Xi′an 710068
关键词:
心包积液　容积—压力关系　正常心包压
Keywords:
pericardial effusion　　relationshop of pericardial volume-pressure　　normal pericardial pressur
分类号:
-
DOI:
-
文献标识码:
-
摘要:
16例中到大量心包积液患者在X线下使用Seldinger法,经剑突下穿刺心包放置7F导鞘,心包造影,定量抽液及压力测定。资料完整的15例患者显示:心包腔内压力与心包积液量无相关性。有心包填塞症状者,当抽液量达到150 ml时, 心包内压力下降曲线最为陡峭: 幅度最大, 而以后随积液量减少,压力下降徐缓。当抽液到250 ml时心包腔舒张压在0.40 kPa～-1.46 kPa之间,大多数低于文献报道的右房舒张压。在积液基本抽完时,12例心包腔平均压在0～-1.33 kPa之间,最低可达-2.0 kPa,与胸膜腔压近似。1例有肺气肿的老年患者和2例有胸腔积液者压力在0.13 kPa～0.53 kPa 之间。
Abstract:
There were 16 patients with medium to large volumes of pericardial effusion in this study.Using the Seldinger technigue, a 7-French sheath tube,in the xiphocoastal puncture approach,was introduced, under fluroscopic guidance, into the pericaridal space for drawing effusion,measuring pressure and pericardiography. Fifteen patients finished the trial. The results showed there was no correlation in the pericardial volume-pressure relationship. In the patients with cardiac tamponade, the pericardial pressure tracings decreased sharply when 150 ml of effusion was removed. After this,following continual aspiration, the pericardial pressure decreased slowly. When 250 ml of effusion was removed,the pericardal diastolic pressure was significantly lower than the right atrial diastolic pressure. When the pericardial effusion was nearly completely removed, the average pericardial pressure was between 0kPa～1.33 kPa in 12 patients, the lowest being -2.0 kPa, which was similar to the pleural pressure.The pericardial pressures of the three patients, one with pulmonary emphysema and the other two with pleural effusion,were 0.13 kPa～0.53 kPa.

参考文献/References

［1］chandrata PAN. Echocardiography and Doppler ultrasound in the evaluation of pericardial disease. Circulation, 1992; 84 (Suppl Ⅰ):303.

［2］Kralstein J , Frishman W ,Bronx NY. Malignant pericardial disease:Diagnosis and treatment. Am Heart J , 1987; 113: 785.

［3］Armstrong WF, Schilt BF, Helper DJ, et al.Diastolic collapse of the right ventricule with tamponade: An echocardiographic study. Circulation, 1982; 65: 9491.

［4］Santamore AMP, Heckman JL ,Bove AA. Right and left ventricular pressure-volume response to elevated pericardial pressure. Am Rev Respir Dis, 1986; 134: 101.

［5］毛继文, 孙瑞龙, 主编. 心导管检查及诊断. 第1版. 长春: 吉林人民出版社, 1991: 112.

［6］Boltwood CM , SkulsyA ,Drinkwater CD, et al. Intraoperative measurement of pericardial constraint: Role in ventricular diastolic mechanias. JACC, 1986; 8: 1289.

［7］谷伯起, 主编. 心血管病理学. 第1版. 北京: 人民卫生出版社,1992: 26.

备注/Memo

备注/Memo:
(收稿1999-02-03　修回1999-09-21)
更新日期/Last Update: 1999-07-01