https://scholars.lib.ntu.edu.tw/handle/123456789/551796
標題: | Technical and prognostic outcomes of double-balloon pericardiotomy for large malignancy-related pericardial effusions | 作者: | Wang H.-J. Hsu K.-L. FU-TIEN CHIANG Tseng C.-D. Tseng Y.-Z. Liau C.-S. |
關鍵字: | Cancer; Cardiac tamponade; Percutaneous balloon pericardiotomy; Pericardial effusion; Pericardiocentesis | 公開日期: | 2002 | 卷: | 122 | 期: | 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: | https://scholars.lib.ntu.edu.tw/handle/123456789/551796 | ISSN: | 0012-3692 | DOI: | 10.1378/chest.122.3.893 | SDG/關鍵字: | adult; aged; article; breast carcinoma; calcium blood level; cancer survival; cause of death; clinical article; controlled study; cytology; echocardiography; female; human; intensive care unit; lung carcinoma; male; pericardial effusion; pericardiocentesis; pericardiotomy; pneumothorax; postoperative complication; priority journal; prognosis; safety; surgical technique; thorax radiography; treatment indication; treatment outcome |
顯示於: | 醫學院附設醫院 (臺大醫院) |
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