https://scholars.lib.ntu.edu.tw/handle/123456789/202170
標題: | Technical and Prognostic Outcomes of Double-Balloon Pericardiotomy for Large Malignancy-Related Pericardial Effusions | 作者: | WANG, HUANG-JOE CHIANG, FU-TIEN TSENG, CHUEN-DEN TSENG, YUNG-ZU LIAU, CHIAU-SUONG HSU, KWAN-LIH |
關鍵字: | cancer;cardiac tamponade;percutaneous balloon pericardiotomy;pericardial effusion;pericardiocent;CARDIAC-TAMPONADE | 公開日期: | 2002 | 卷: | v.122 | 期: | n.3 | 起(迄)頁: | 893-899 | 來源出版物: | CHEST | 摘要: | Objective: To investigate both the use of immediate or elective double- balloon pericardiotomy (DBP) in patients with a large amount of malignancy -related pericardial effusion, and the prognosis of this subgroup. Design: Observational study after DBP intervention. Setting: Tertiary referral center. Patients and interventions: Fifty patients with malignancy, mainly lung and breast cancer, who were admitted to our critical care unit with a large amount of pericardial effusion. All received echocardiographic- guided pericardiocentesis. Group 1 consisted of 12 patients( 24%) who received immediate DBP, and group 2 consisted of 38 patients (76%) who received delayed DBP 2.5 +/- 1.7 days later (mean +/- SD) after emergency pericardiocentesis with pigtail catheter drainage. Measurements: After the procedure , and at 1 month, 3 months, and 6 months, echocardiography and chest radiography were performed to check for pneumothorax, pericardial effusion reaccumulation, or the appearance of pleural effusion after pigtail catheter removal. Main results: The procedure was successful and without recurrence in 44 patients (88%). Procedural complications were fever in 4 patients (33%) and 10 patients (26%) in group 1 and group 2, respectively (p = 0.72), and mild pneumothorax in 2 patients (17%) and 1 patient (3%) in group 1 and group 2, respectively (p = 0.14). Fifty percent of the patients died within 4 months, while 25% survived to 11 months. High serum calcium, a low albumin/globulin ratio, and positive results on pericardial effusion cytology were poor prognostic factors for long-term survival. Conclusion: Both immediate and delayed DBP are a safe and effective method of relieving large pericardial effusions in patients with cancer. Successful DBP without recurrence of pericardial effusion was achieved in 88% of all patients. Survival was related to the extent of the disease. |
URI: | http://ntur.lib.ntu.edu.tw//handle/246246/103339 |
顯示於: | 醫學系 |
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