慢性缩窄性心包炎的手术治疗及相关因素探讨推荐到首页 □ 《中华医学研究杂志》2004年第05期1/4页1234
【关键词】心包炎
【摘要】目的总结分析203例慢性缩窄性心包炎患者施行心包剥脱术的治疗体会，探讨影响手术疗效的相关因素。方法对1960～2001年期间，203例因缩窄性心包炎行心包剥脱术的患者临床资料进行回顾性研究。从手术时机的选择、病因、心包剥脱范围以及并发症处理等方面进行讨论。结果203例中手术死亡6例，手术死亡率为2.96%;其余197例（97.05%）症状均明显缓解出院。189例（93.10%）获得长期随访，随访期6个月～31年（平均12.23±7.61年）。绝大多数患者术后6个月内心功能恢复至～级，能从事中等程度体力劳动以上141例（74.60%），症状改善者42例（22.22%），无明显改善者6例（3.17%）。晚期复发心包缩窄或因心力衰竭死亡7例（3.45%）。结论心包剥脱术是治疗慢性缩窄性心包炎的可靠有效方法，根据病情选择适当的手术时机，尽早剥除缩窄心包，加强围手术期处理，可获得更优的治疗效果。关键词慢性缩窄性心包炎心包剥脱术
surgicaltreatmentofchronicconstrictivepericarditisfor203patients
yangshuangqiang，liliangbin，liqiang，etal.
departmentofcardiothoracicsurgery，thefirstaffiliatedhospital，
chongqinguniversityofmedicalsciences，chongqing400016.
【abstract】objectivetosummarizetheexperiencesofsurgicaltreatmentfor203patientswithchronicconˉstrictivepericarditisforwhompericardiectomyprocedureswereperformed，andtoexploretherelativefactorsinfluencˉingoperativeeffect.methodsretrospectivestudyon203pericardiectomycasesfrom1960to2001werecarriedoutbasedonclinicaldata，anddiscussionwerefocusedonvariousissuessuchasselectionofoperativeopportunity，etioloˉgy，pericardiectomycoverage，andcomplicationmanagament，etc.resultstherewere6earlymortalitycases（2.96%）and197survivaldischargedcases（97.05%）amongall203patients.long-termfollow-upwereobtainedfrom189cases（93.10%）since3monthsto41years（averaged12.23±7.61years）.mostofthepatientswerereˉcoveredtonyha～classwithin6monthsafterpericardiectomy，with141cases（74.60%）moderatelabour，42cases（22.22%）symptomimprovement，and6cases（3.17%）noimprovement.7latemortalitycases（3.45%）beˉcauseofrefractoryconstrictivepericarditisandheartfailurewerediscovered.conclusionpericardiectomyisaneffecˉtivesurgicaltreatmentforchronicconstrictivepericarditispatients.optimalclinicaloutcomewouldbereachediftherighttimeforoperationwasselectedandconstrictivepericardiumwasremovedcompletely.perioperativemanagementisverycriticaltoeveryindividualpatientaswell.
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