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| 불응석 요독성 심낭 삼출에서 검아돌기하 심낭줄어들개술 치험 2예 |
| 김문재 , 믹순혜 , 인현호 |
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| Abstract |
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Pericardial diseases often cause morbidity and mor- tality as potentially major complication in patient with chronic renal failure. The primary treatment of uremic pericarditis has been to start dialysis in previously undialyzed patients or to intensify dialysis, particularly when pericardial effusion is small or moderate amount. Surgery should be initiated in patient with uremic per- icarditis in whom a moderate to large effusion does not diminish or actually increases in size following dialysis. We experience with subxiphoid pericardiostomy for massive pericardial effusion in two patients on mainte- nance hemodialysis. A 31-year-old man in maintenance hemodialysis was hospitalized for increasing shortness of breath for one month. Echocardiogram demonstrated a massive pericardial effusion. A subxiphoid pericar- diostomy was performed in the operating room. The pericardial drainge tube was removed 3 days later, and a repeated echocardiogram revealed no more accumula- tion of the effusion. A 37-year-old man with chronic renal failure on hemodialysis was hospitalized for in- creasing shortness of breath, chest pain, and low blood pressure. The symptoms were aggravated during the dialysis. An emergency echocardiogram done at the patients bedside showed moderate amount of pericar- dial effusion and pericardial tamponade. Emergency subxiphoid pericardiostomy was performed using local anesthesia. There were immediate improvements from tamponade state after pericardiostomy drainage. |
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