心包穿刺术
定义
心包穿刺术 is a procedure that uses a needle to remove fluid from the pericardial sac. This is the tissue that surrounds the heart.
选择的名字
Pericardial tap; Percutaneous pericardiocentesis; 心包炎 - pericardiocentesis; Pericardial effusion - pericardiocentesis
How the Test is Performed
The procedure is most often done in a special procedure room, such as a cardiac catheterization laboratory. It may also be done at a patient's hospital bedside. A health care provider will put an
The provider will clean an area just below or next to the breastbone or below the left nipple. Numbing medicine (anesthetic) will be applied to the area.
The doctor will then insert a needle and guide it into tissue that surrounds the heart. 通常,
Once the needle has reached the correct area, it is removed and replaced with a tube called a catheter. Fluid drains through this tube into containers. 大多数时候, the pericardial catheter is left in place so draining may continue for several hours.
Surgical drainage may be needed if the problem is hard to correct or comes back. This is a more invasive procedure in which the pericardium is drained into the chest (pleural) cavity. Alternatively, the fluid may be drained into the peritoneal cavity, but this is less common. This procedure may need to be done under general anesthesia.
How to Prepare for the Test
You may not be able to eat or drink for 6 hours before the test. You must sign a consent form.
考试的感觉如何
You may feel pressure as the needle enters. 有些人有
Why the Test is Performed
This test may be done to remove and examine fluid that is pressing on the heart. It is most often done to find the cause of a chronic or recurrent
It may also be done to treat
正常的结果
There is normally a small amount of clear, straw-colored fluid in the pericardial space.
What Abnormal Results Mean
Abnormal findings may indicate the cause of pericardial fluid accumulation, such as:
癌症 - 心脏穿孔
- 心脏创伤
Congestive heart failure 心包炎 - 肾功能衰竭
- 感染
- Rupture of a ventricular
动脉瘤
风险
风险可能包括:
- 出血
- 肺功能衰竭,
- 心脏病
- 感染 (pericarditis)
- Irregular heartbeats (
心律失常 ) - Puncture of the heart muscle, coronary artery, lung, liver, or stomach
- Pneumopericardium (air in the pericardial sac)
参考文献
嘿,BD,哦,JK. 心包疾病. In: Goldman L, Schafer AI, eds. Goldman-Cecil Medicine. 26日艾德. Philadelphia, PA: Elsevier; 2020:chap 68.
Lewinter MM, Cremer PC, Klein AL. 心包疾病. In: Libby P, Bonow RO, Mann DL, Tomaselli GF, Bhatt DL, Solomon SD, eds. Braunwald's Heart Disease: A Textbook of Cardiovascular Medicine. 12日艾德. Philadelphia, PA: Elsevier; 2022:chap 86.
Mallemat HA, Tewelde SZ. 心包穿刺术. In: Roberts JR, Custalow CB, Thomsen TW, eds. Roberts and Hedges' Clinical Procedures in Emergency Medicine and Acute Care. 7日艾德. Philadelphia, PA: Elsevier; 2019:chap 16.
审核日期: 05/08/2022
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