Analysis Of Clinical Characteristics Of Patients With Pericardial Effusion Who Require Pericardiocentesis And Drainage

Objective:Investigating the Clinical characteristics of Patients with pericardial effusion who require pericardiocentesis and drainage, as to direct the diagnosis and therapy.Methods:We prospectively statistical analyzed the clinical data, etiology and the pericardial effusion's properties of patients with pericardial effusion who requiring pericardiocentesis and drainage in 202 consecutive Han Chinese patients.Results:Pericardiocentesis and drainage was successfully performed and effective in all patients, except 11 cases with acute myocardial infarction. In 191 patients with pericardial effusion, there were 12 cases with transudates, while the remaining 179 cases were diagnosed with exudates (neoplastic in 76 patients, tuberculous in 63 patients,10 cases of connective tissue diseases,18 cases undergoing cardiac catheterization, and 15 cases of acute myocardial infarction). Among the 76 malignancies pericardial effusion,42 patients had lung cancer,7 had breast cancer,6 had metastatic adenocarcinoma with unidentified primary foci,6 had lymphoma,4 had liver cancer and 3 had mediastinal tumor. The tuberculosis pericardial effusion group was younger than the malignant pericardial effusion group (P<0.05). In the positive rate of tuberculin test, the tuberculosis group was higher than the malignant group (P<0.01). No significance differences in the clinical characteristics (as:gender, fever, hemoglobin, blood sedimentation, blood lactate dehydrogenase and adenylate deaminase) and the results of routine and biochemistry studies(like:lactate dehydrogenase and adenylate deaminase) in the pericardial fluid between tuberculous and malignant groups were found. Of the 18 patients undergoing cardiac catheterization,10 cases had undergone catheter ablation for tachycardia and 6 cases had undergone percutaneous coronary intervention. The radio of the iatrogenic pericardial effusion complicated by catheter ablation for tachycardia was higher in female than male. Pericardiocentesis and drainage was effective in the 9 patients who underwent catheter ablation, and the remaining 9 patients underwent surgical intervention after pericardiocentesis and drainage. All 15 patients with acute myocardial infarction died during hospitalization.Conclusion:Pericardial effusions requiring pericardiocentesis and drainage were exudates and bloody, which were mainly caused by malignancy and tuberculosis. However, the incidence of iatrogenic pericardial effusion and acute myocardial infarction has been increasing and should not be ignored. Pericardiocentesis and drainage were a effective intervention in salvage and treatment, but mortality of acute myocardial infarction combined with pericardial effusion is sky-high.