摘要
目的：研究心包积液时右心房与心包腔内压力关系，并对心包填塞分级。方法：采用右心导管和剑突下穿刺术，同步连续测定１５例患者的右房和心包腔内压力，直到心包造影证实积液基本抽完时为止。结果：心包积液时，右房压始终高于心包压，压差随心包内压力升高而减小，范围从０１３～０．４０ｋＰａ。心包填塞者，当抽液到１５０ｍＬ时，右房和心包内压力下降曲线最为陡峭。压力越高，下降幅度越大。当抽液２５０ｍＬ时，心包舒张压显著低于右房舒张压。结论：在心包填塞时，右房和心包腔内压力相近，但不相等，前者稍高于后者。在心包积液基本抽完时，心包压与胸膜压相近似。依据右房压，可将心包填塞程度分为无症状、轻、中、重和危象５级。
AIM:To study the relationship between right atrial and pericardial pressure in patients with pericardial effusion, and to grade the cardiac tamponade.METHODS:By right heart catheterization and subxiphoid approach, 15 patients with large pericardial effusion were synchronizely measured the pressure of right atrium and pericardium, until the effusion was completly aspirated which was demonstrated by pericardiography.RESULTS:The right atrial pressure (RAP) was consistently higher(0.13 ～0.40 kPa)than pericardial's in cardiac tamponade Pressure difference was decreased by raising of pericardial pressure.In patients with cardiac tamponade, the tracings of atrial and pericardial pressure declined sharply following removal of 150 mL effusion, and the higher pressure it was, the larger extent the pressure fell. When 250 mL effusion was aspriated, pericardial diastolic pressure was significantly below RAP.CONCLUSIONS:RAP was approximate pericardial pressure in cardiac tamponade, but not equal to it, the former was higher than the later. When the effusion was almost completely withdrawn, pericardial pressure was more similar to pleural pressure. According to RAP, cardiac tamponade could be divided into five degrees:asymptom, mild, moderate, severe and dangerous.
出处
《中国病理生理杂志》
CAS
CSCD
北大核心
1999年第3期275-277,共3页
Chinese Journal of Pathophysiology
关键词
心包积液
心房功能
右心房
腔内压力
Pericardial effusion
Atrial function, right
Pericardium
