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各种外科手术包括心包切除术和心包开窗术曾用于治疗恶性心包积液,但大多数病人需全身麻醉和开胸。目前的治疗方法主要是经皮心包引流和注入各种硬化剂、化疗药物或放射性同位素。作者报告心包内注入四环素治疗58例心包积液的经验。58例恶性心包渗出患者诊断确立后经皮插入 Kifa6.5Fr 导管引流12～24小时,然后将盐酸四环素0.5～1g 溶于10～20ml 生理盐水中经导管注入心包腔。54例于注入四环素前先注入利多卡因100mg。注四环素后夹管1～2小时,然后续继引流。每24～48小时重复注入1次直至引流液少于25ml/24h 为止。经超声心动图证实无心包积液后拔管。
Various surgical procedures including pericardiotomy and pericardial fenestration have been used to treat malignant pericardial effusions, but most require general anesthesia and thoracotomy. The current treatment is mainly percutaneous pericardial drainage and injection of various sclerotherapy, chemotherapy drugs or radioisotopes. The authors report the pericardial infusion of tetracycline in the treatment of 58 cases of pericardial effusion experience. 58 cases of malignant pericardial exudation after the establishment of the diagnosis of percutaneous Kifa6.5Fr catheter drainage for 12 to 24 hours, and then tetracycline hydrochloride 0.5 ~ 1g dissolved in 10 ~ 20ml normal saline into the pericardial catheter. Fifty-four patients received lidocaine 100 mg before tetracycline infusion. Note tetracycline pinch 1 to 2 hours, and then continue to drain. Every 24 to 48 hours repeated injection 1 until drainage fluid less than 25ml / 24h so far. Echocardiography confirmed extubation without extubation.