超声引导下心包腔内置入中心静脉导管治疗大量心包积液的临床研究.pdf

nullS5null超声引导下心包腔内置入中心静脉导管治疗大量心包积液的临床研究朱先存,左鲁生,黄远洋,欧广超,张兆昕nullK1null研究超声引导下心包腔内置入中心静脉导管治疗大量心包积液的价值bZE18例大量心包积液患者在超声实时监视和引导下进行心包腔穿刺,置入中心静脉导管进行引流a冲冼a心包内注药治疗,观察疗效a安全性a不良反应和并发症bT18例患者均一次置管引流成功,治愈16例,治愈率88.9%,显效2例,显效率为11.1%,无一例发生不良反应和并发症b超声引导下心包腔内置入中心静脉导管具有安全a操作简便a疗效显著a无不良反应和并发症a血流动力学影响小等优点,可作为治疗大量心包积液的首选方法bnull1oMnull心包积液；超声引导；中心静脉导管nullms|nullR542.12R445.12nullDSMnullAnullcI|null1674null4152(2010)07null0866null02TheClinicValueofUltrasonographynullGuidedPericardiocentesisandPlacementofCentralVenousCathetertoTreatLargeNumberofThePericardialEffusionZHUXiannullcun,ZUOLunullsheng,HUANGYuannullyang,etal.DepartmentofSpecialDiagnosis,the123thHospitalofPLA,Bengbu233015,Anhui,ChinanullAbstractnullObjectiveToinvestigatetheclinicvalueofultrasonographynullguidedperiicardiocentesisandplacementofcentralvenullnouscathetertotreatalargenumberofthepericardialeffusion.MethodsTheefficacy,safety,adversereactionsandcomplicanulltionsof18casesofpatientswithalargenumberofpericardialeffusionwasobserved,aftertheywereplacedcentralvenouscathenullterfordrainage,flushing,intrapericardialinjectiontreatmentunderultrasonographynullguidedandrealnulltimemonitoring.ResultsAllofthe18patientswereplacedcatheteranddrainedsuccessfulonetime,16patientswerecured,thecureratewas88.9%,2panulltientswereeffective,theeffectiveratewas11.1%,noadversereactionorcomplicationoccurred.ConclusionUltrasonographynullguidedpericaridiocentesisandplacementofcentralvenouscatheterhadadvantageofsafety,simple,highefficacy,noadversereacnulltionorcomplicationandlowinfluenceonhemorheology,whichcanbethefirstchoicemethodstotreatalargenumberoftheperinullcardialeffusion.nullKeywordsnullPericardialeffusion；Ultrasonographynullguided；CentralvenouscalthterizationvAA,#H|n,#3,2002M2/T:2330158g,b+123D+SYT:5i,0Q:8=5vA18r4,rTi,C/b1ZE1null1临床资料18314,o4；M-40M1ybm71,?3aA8,YF7WL1bQ=aF,Vhah8aPFL,H%F!MTb6?f,F?v,yH5K,5sb,H8=l=W7F,%l,M?zA78,VE8,yNHVg8,7dB1F9bHg8*K:#HFK,98(6.4cm3.3cm0.7cm,HvlB1,YgAs10b?g8Fv7,TFV5cmH,*9ZA111b%HJ,HJ,vHF$M1yB,Y4b&7gsK,yV?%*8FH11,Afg2b8,HMg8*mTeaqaMg7a?p,Bzg8*ZTbg8*vhzPN,-zbID1?,.Hg8J.SyS,2006,20(9):893null895.2ColellaG,TartaroG,GiudiceA.ThebuccalfatpadinoralreconstrucnulltionJ.BritishAssociationofPlasticSurgeons,2004,57(4):326null329.3RapidisAD,AlexandridisCA,EleftheriadisE,eta.lTheuseofthebuccalfatpadforreconstructionoforaldefects:Reviewoftheliteranulltureandreportof15casesJ.JOralMaxillofacSurg,2000,58(2):158null163.4DeanA,AlamillosF,GarcianullLopezA,eta.lThebuccalfatpadflapinoralreconstructionJ.HeadNeck,2001,23(5):383null388.5AminMA,BaileyBM,SwinsonB,eta.lUseofthebuccalfatpadinthereconstructionandprostheticrehabilitationofoncologicalmaxillarydefectsJ.BrJOralMaxillofacSurg,2005,43(2):148null154.61,.HMyJ.S,2003,19(1):5null7.7K,6,1.HM5#FJ.g8D,2001,21(6):180null182.8y,5A8,2nAA；Ar:5h,2AAh；r:5AFb2null2治疗效果显著18(BQ,O5,8A8,10A8,BCQi?b2null3治愈率高1816,Ar2,q88.9%,Arq11.1%b3)3null1心包积液形成的原因s#C,W8YA8,BV50m,l#lfT,2m_Y?Cb?3%hH,8=A8A9,#_?C8/=(nAuOzv2cmH,5vA,Y0a4A,NH1|$)bDAy1?aaaUa4bNF1?aa,AVFFA(?Ah,71,Ob3null2超声引导中心导管导管引流的优点.d,OZE:B-u,P5,6W#$=,_a_=_,Z_O8；6B/,O,tlP7)/T,O,OZ_C45(O_aa_P78/b.d,O,3ai?5,iOTD31,Ob72/,O2_AUAKvA,O,O124,Oa,OZ_a,O,OV2LHSj/,vv4,Oq,O?E12,hi?3byN,2/,O.d,OaeLa,TD=,O/1p9b5y:#5,OH#,Ol,M8H.e；%55FMz,=HW；&5d,sa!#8=90b3null3中心静脉导管置入治疗效果明显2/8=5vA,h(BQ,O,BQ,Oq100%,1816,Ar2,q88.9%(16/18),Arq11.1%(2/18)bBC3apaai?,DMB6-11b2/8=5aeLVLarAai?,H|,Oa5a8=0Bi,EQ,OQA,iOVH,?rEhi?,VTvAnZEb3null4中心静脉导管置入时的注意事项2/8=5A1i/+:#4,O,O11,1p4AKv,8VKO,O1#,O41aPaa/aa=aa|；%ARRy,yyM7kai?,A1HVW；&A81M1_,LBAy,V78；)hy_8=M0,?50,5_8F0；A81kYA,OV5；+,O,1%,E5；,58=bHWV,5V30d,V30d1