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目的 报道因心脏介入手术所致的 12例心脏压塞病例 ,分析其可能原因、临床表现及治疗结果 ,随访其预后。方法 5 0 4 0例心脏介入手术中共发生 12例心脏压塞 ,男性 4例 ,女性 8例 ,平均年龄 (5 6± 17)岁 ,其中 8例与导管标测和射频消融术有关 ,2例与经皮冠状动脉腔内成形术有关 ,2例与先天性心脏病介入治疗有关。结果 心脏压塞的主要原因包括左心室穿孔、心脏静脉破裂、冠状动脉和左心耳穿孔。 8例经立即心包穿刺抽液 15 0～ 10 0 0ml病情稳定 ,4例因出血量大进行了外科手术。出院后平均随访 (2 3 6± 13 1)个月 ,全部病人情况良好。结论 心脏压塞是心脏介入治疗过程中严重的并发症 ,及时发现和有效处理十分重要。
Objective To report 12 cases of cardiac tamponade caused by cardiac interventional surgery and analyze its possible causes, clinical manifestations and treatment outcomes. The prognosis was followed up. Methods A total of 12 cases of cardiac tamponade were performed in 50 040 heart interventional procedures, including 4 males and 8 females, with an average age of (56 ± 17) years, 8 of whom were related to catheterization and radiofrequency catheter ablation. And percutaneous transluminal coronary angioplasty, 2 cases and congenital heart disease interventional therapy. Results The main causes of cardiac tamponade include left ventricular perforation, rupture of the heart vein, perforation of the coronary arteries and left atrial appendage. 8 cases of immediate pericardial aspiration 150 ~ 10 0ml stable condition, 4 cases of bleeding due to large surgical. After discharge, the average follow-up was (236 ± 131) months. All the patients were in good condition. Conclusions Cardiac tamponade is a serious complication of cardiac interventional therapy. It is very important to discover and manage it promptly.