Abstract：Objective To explore the surgical treatment strategy about severe constrictive pericarditis.Methods From January 2007 to June 2017, 37 patients with severe constrictive pericarditis who underwent surgical treatment were retrospectively analyzed in Department of Cardiac Surgery,the First Affiliated Hospital of Bengbu Medical College. Of the 37 patients, 26 were males and 11 were females. The average age was (38.42±17.21)years, range from 22 to 73 years old . The disease course ranged from 3 months to 5 years. There were 12 patients of cardiac cachexia, 5 patients of low cardiac output syndrome, 12 patients of severe anemia and hypoproteinemia, 2 patients of severe renal insufficiency and 8 patients of hepatic insufficiency. Preoperative central venous pressure was 16 to 35 cmH2O(1 cmH2O=0.018 kPa), of which 28 patients were more than 20 cmH2O. New York Heart Association(NYHA) classification of cardiac function: 15 patients of class Ⅲ and 22 patients of class Ⅳ. Pericardial exfoliation was performed in all patients. The recovery of cardiac function after operation was observed.Results In this group of the 37 patients, 2 patients died during the operation, and the rest of the patients were successfully operated. The operation time was 1.5 to 3 h, with an average of 2 h. In all 37 patients, central venous pressure(CVP) dropped to less than 20 cmH2O after operation, of which 26 patients were below 14 cmH2O. Hypo-cardiac output syndrome occurred in 5 patients, 1 patient died, and 4 patients improved. There were 6 patients of arrhythmia, 3 patients of acute renal insufficiency and 4 patients of respiratory insufficiency. The clinical symptoms of the other 17 patients improved gradually after operation. Postoperative cardiac function was improved,NYHA classⅠ24 patients, classⅡ 9 patients, class Ⅲ 1 patient. The chest CT was reviewed after operation 3 months to observe that there was no calcification in the pericardial operation area. 34 patients were followed up for 0.5 to 10 years with the average of 4.6 years and basically resumed their daily work and life.Conclusions Severe constrictive pericarditis is serious and complications, which should be diagnosed early, active surgical treatment. It is necessary to strengthen that management of the preoperative period and develop a rational treatment plan, in which the precise sequence and range of pericardial ablation can be used to improve the success rate of the operation and to reduce the incidence of postoperative complications.
李海慧, 刘以尧, 施超, 刘戈, 孟金金, 刁文杰, 申国争 张娜娜, 石宇, 刘学刚. 重症缩窄性心包炎外科治疗37例临床分析[J]. 中华解剖与临床杂志, 2018, 23(2): 126-130.
Li Haihui, Liu Yiyao, Shi Chao, Liu Ge, Meng Jinjin, Diao Wenjie, Sheng Guozheng, Zhang Nana, Shi Yu, Liu Xuegang. A clinical analysis of 37 patients with severe constrictive pericarditis who underwent surgery. Chinese Journal of Anatomy and Clinics, 2018, 23(2): 126-130.
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2018, Vol. 23 
