Treatment of Pericardial Effusion Through Subxiphoid Tube Pericardiostomy and Computerized Tomography- or Echocardiography - Guided Percutaneous Catheter Drainage Methods

Abstract Objective: In this retrospective study, we aimed to observe the efficacy of pericardial effusion (PE) treatments by a survey conducted at the Department of Cardiovascular Surgery, Faculty of Medicine, Atatürk University. Methods: In order to get comparable results, the patients with PE were divided into three groups - group A, 480 patients who underwent subxiphoid pericardiostomy; group B, 28 patients who underwent computerized tomography (CT)-guided percutaneous catheter drainage; and group C, 45 patients who underwent echocardiography (ECHO)-guided percutaneous catheter drainage. Results: In the three groups of patients, the most important symptom and physical sign were dyspnea and tachycardia, respectively. The most common causes of PE were uremic pericarditis in patients who underwent tube pericardiostomy, postoperative PE in patients who underwent CT-guided percutaneous catheter drainage, and cancer-related PE in patients who underwent ECHO-guided percutaneous catheter drainage. In all the patients, relief of symptoms was achieved after surgical intervention. There was no treatment-related mortality in any group of patients. In patients with tuberculous pericarditis, the rates of recurrent PE and/or constrictive pericarditis progress were 2,9% and 2,2% after tube pericardiostomy and ECHO-guided percutaneous catheter drainage, respectively. Conclusion: Currently, there are many methods to treat PE. The correct treatment method for each patient should be selected according to a very careful analysis of the patient's clinical condition as well as the prospective benefit of surgical intervention.

摘要
目的：本项回顾性研究旨在通过阿塔图尔克大学医学院心血管外科开展的调查，观察心包积液（pericardial effusion, PE）的治疗疗效。
方法：为获取具有可比性的研究结果，将心包积液患者分为三组：A组480例接受剑突下心包造口术（subxiphoid pericardiostomy）；B组28例接受计算机断层扫描（computed tomography, CT）引导下经皮导管引流术；C组45例接受超声心动图（echocardiography, ECHO）引导下经皮导管引流术。
结果：三组患者最主要的临床症状与体征分别为呼吸困难与心动过速。接受剑突下心包造口术的患者中，心包积液最常见的病因为尿毒症性心包炎；接受CT引导下经皮导管引流术的患者中，术后心包积液为最常见病因；接受ECHO引导下经皮导管引流术的患者中，癌相关性心包积液为最常见病因。所有患者经外科干预后症状均得到缓解，各组均未出现治疗相关死亡。在结核性心包炎患者中，接受剑突下心包造口术与ECHO引导下经皮导管引流术者的心包积液复发率及/或缩窄性心包炎进展率分别为2.9%与2.2%。
结论：目前临床用于治疗心包积液的方法众多，应在对患者临床病情及外科干预的预期获益进行细致分析后，为每位患者选择恰当的治疗方案。