心包积液67例临床表现的多样性及病因分析

摘要

Objective Retrospectively review the records of 67 patients with pericardial effusion as the primary manifestation,and analyze the etiological factors and prognosis.Method We retrospectively studied 67 patients with pericardial effusion as the primary manifestation in nearly 20 years.Result The construction of etiological factors:malignant pericardial effusion(30 patients),tubercular pericardial effusion(16 patients),pericardial effusion caused by heart failure(8 patients),nonspecific pericardial effusion(6 patients),hypothyroid pericardial effusion(4 patients),pericardial effusion associate with SLE(3 patients).Prognosis is obviously correlated with etiological factors,and patients'condition aggravate if therapy delayed.Conclusion The proportion of patients with malignant pericardial effusion is elevating in patients with pericardial effusion as the primary manifestation.Malignant pericardial effusion is becoming the initial etiological factors and has no obvious feature of age distribution.Thus we need to actively follow-up patients with recurrent attacked pericardial effusion to exclude malignant tumor.%目的 回顾以心包积液为主要临床表现而就诊的病例,分析其病因及治疗预后.方法 总结近20年来以心包积液为主要临床表现而就诊的患者共67例.结果 病因构成:肿瘤性心包积液30例,占首位,其他依次是结核性心包积液16例,心力衰竭致心包积液(心包积水)8例,非特异性心包积液6例,甲状腺机能减退症心包积液4例,系统性红斑狼疮心包积液3例.病情预后与病因明显相关,但诊疗不及时可使病情恶化.结论 肿瘤性心包积液在以心包积液为首诊的患者中的比例有明显升高趋势,目前为首要发病因素,且无明显年龄分布特点,对反复发作的心包积液需积极随访检查除外恶性肿瘤.