超声引导锥形套管针穿刺在心脏压塞救治中的应用

发布时间：2017-12-27 12:01

本文关键词：超声引导锥形套管针穿刺在心脏压塞救治中的应用　出处：《中国微创外科杂志》2016年02期 　论文类型：期刊论文

【摘要】：目的探讨超声引导下锥形套管针穿刺在心脏压塞救治过程中的应用价值。方法 1998年3月~2015年10月,在超声引导下使用锥形套管针(专利号:ZL 2006 2 0132265.8)对28例大量心包积液(心包积液宽度≥17 mm)引起的心脏压塞进行心包穿刺,置入引流管引流。选择Seldinger法心包置管治疗心脏压塞患者28例作为对照组,比较2组的置管时间。结果所有心脏压塞患者均一次穿刺成功并置入引流管,锥形套管针组置管时间(6.2±1.1)min,比Seldinger组(15.0±1.1)min明显缩短(t=-27.844,P=0.000),引流后患者心脏压塞症状均消失。结论在大量积液引起的心脏压塞患者的救治过程中,超声引导下锥形套管针穿刺置管操作简便,创伤小,快速安全,疗效确切,也为后续治疗提供了保障。
[Abstract]:Objective to evaluate the value of conical cannula puncture under the guidance of ultrasonic guidance in the treatment of cardiac tamponade. March 1998 ~2015 year in October, in the use of conical trocar guided by ultrasound (Patent No.: ZL 200620132265.8) of 28 cases of pericardial effusion (pericardial effusion width more than 17 mm) induced cardiac tamponade pericardiocentesis, placement of drainage tube drainage. 28 cases of cardiac tamponade were treated by Seldinger pericardial catheterization as control group, and the time of catheterization was compared between the 2 groups. Results all patients with cardiac tamponade were successfully punctured and drained into the drainage tube at once. The time of catheter placement in the conical trocar group was (6.2 + 1.1) min, which was significantly shorter than that in group Seldinger (15 + 1.1) min (t=-27.844, P=0.000), and the symptoms of cardiac tamponade disappeared after drainage. Conclusion during the treatment of patients with cardiac tamponade caused by a large number of effusion, ultrasound-guided taper trocar puncture and catheterization is simple, minimally invasive, safe and effective, and provides a guarantee for subsequent treatment.
【作者单位】：山东省青岛市黄岛区第二人民医院超声科;山东省青岛市黄岛区第二人民医院心内科;
【基金】：青岛市黄岛民生计划项目(2014-2-21)
【分类号】：R445.1;R54
【正文快照】： 心脏压塞由大量心包积液或积血引起,需紧急处理。心包穿刺置管引流是目前治疗心脏压塞的首选方法,但心包穿刺存在较大风险,稍有不慎容易造成心肌、冠状动脉、肺和膈肌损伤,严重者造成心律失常甚至死亡[1~3]。如何安全快速地实施心包穿刺是临床急需解决的难题,传统的Seldinger

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