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目的 观察 Seldinger导管法穿刺并抗结核治疗结核性心包炎的临床疗效。方法 11例住院病人均采用 Seldinger导管法 ,剑突下穿刺并保留导管引流 ,间断腔内冲洗及注射地塞米松、卡介苗素 ,确诊后予 2 S( E) HRZ/4H3 R3 方案抗结核治疗 ,定期复查超声心动图、肝功能等。结果 所有病例心包积液消失并未再产生。未发现心包粘连及心包腔内感染 ,随访过程中除 2例失访外 ,9例完全康复。结论 Seldinger导管法穿刺治疗结核性心包炎 ,安全有效 ,便于留置导管引流 ,腔内冲洗及注射药物 ,合并抗结核治疗可达彻底治愈 ,且并发症少。
Objective To observe the clinical effect of Seldinger catheterization and anti-tuberculosis treatment of tuberculous pericarditis. Methods All 11 inpatients were treated with Seldinger ’s catheter method, puncture under the xiphoid and catheter drainage, intermittent lumen flushing and injection of dexamethasone and BCG, and confirmed by anti - TB treatment with 2 S (E) HRZ / 4H3 R3 regimen. Regular review of echocardiography, liver function. Results All cases of pericardial effusion disappeared and no longer produced. No pericardial adhesions and pericardial infection were found. During follow-up, 9 cases were completely recovered except for 2 cases lost to follow-up. Conclusion Seldinger catheter puncture for the treatment of tuberculous pericarditis, safe and effective, easy to indwelling catheter drainage, intracavitary flushing and injection of drugs, combined anti-TB treatment up to complete cure, and fewer complications.