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本文报告25例有恶性疾病并发大量心包积液的病人应用心包切开引流术进行诊断和治疗。1987年～1988年经超声心动图证实有大量心包积液者75例,选择有恶性疾病或有恶性疾病史者25例行剑突下心包切开术。25例中男性10例,女性15例。年龄26～70岁。乳腺癌8例,肺癌7例,食管癌3例,头颈部恶性肿瘤2例,白血病、淋巴瘤、子宫癌、卵巢癌各1例,原发灶不明1例,恶性渗出11例,其中6例有心包填塞;良性渗出14例,其中3例有心包填塞。25例中22例在局麻下手术,3例在全麻下手术。1例发生术中低血压,需要短暂应用升血压药物。引流液量为100～1250ml,恶性组和良性组无显著差别。恶性组渗液均为血性,而良性组为浆液性、浆液血性和血性。恶性组血清和心包积液中乳酸脱氢酶(LDH)显著高于良性组,但血清和积液LDH比值两组间无显著差别。
This article reports 25 cases of malignant disease complicated with a large amount of pericardial effusion, pericardial drainage and drainage should be used for diagnosis and treatment. From 1987 to 1988 confirmed by echocardiography in a large number of pericardial effusion in 75 cases, choose a malignant disease or malignant disease in 25 cases of xiphoid pericardial pericardiotomy. 25 cases of males in 10 cases, 15 females. Age 26 to 70 years old. 8 cases of breast cancer, 7 cases of lung cancer, 3 cases of esophageal cancer, 2 cases of head and neck cancer, 1 case of leukemia, lymphoma, uterine cancer and ovarian cancer, 1 case of primary tumor and 11 cases of malignant exudation Six cases had pericardial packing; benign exudation in 14 cases, of which 3 cases had pericardial packing. Of the 25 cases, 22 underwent local anesthesia and 3 under general anesthesia. 1 case of intraoperative hypotension, the need for brief application of blood pressure drugs. Drainage volume of 100 ~ 1250ml, no significant difference between benign and malignant group. Malignant exudate are bloody, benign group is serous, serous bloody and bloody. Malignant serum and pericardial effusion lactate dehydrogenase (LDH) was significantly higher than the benign group, but the serum and effusion LDH ratio between the two groups no significant difference.