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目的探讨儿童缩窄性心包炎(CP)临床特点及诊治方法。方法对1980-01—2003-12在重庆医科大学附属儿童医院住院,并经手术确诊的39例CP患儿的临床资料进行回顾性分析。结果主要症状为乏力36例(92·3%)、水肿35例(89·7%)、气促32例(82·0%),主要体征为肝脏肿大35例(89·7%)、颈静脉怒张31例(79·5%)、心音低钝或遥远31例(79·5%)。X线检查阳性率61·5%(24/39),超声心动图检查阳性率76·3%(29/38)。病因确诊为肺吸虫7例、结核5例、化脓性3例,24例病因不清。结论CP临床表现及血流动力学变化与限制性心肌病类似,其鉴别诊断比较困难,目前超声心动图在CP的诊断中仍被认为是最有价值的检查方法。一旦确诊,早期行心包切除术。
Objective To investigate the clinical features and diagnosis and treatment of constrictive pericarditis (CP) in children. Methods A retrospective analysis was performed on the clinical data of 39 cases of CP patients admitted to Children’s Hospital Affiliated to Chongqing Medical University from January 1980 to December 2003. Results The main symptoms were fatigue in 36 cases (92.3%), edema in 35 cases (89.7%), shortness of breath in 32 cases (82.0%) and main symptoms in 35 cases (89.7%) of liver enlargement. There were 31 cases (79.5%) of jugular vein engorgement, 31 cases (71.5%) of low or weak heart sounds. The positive rate of X-ray examination was 61.5% (24/39) and the positive rate of echocardiography was 76.3% (29/38). 7 cases of aetiology diagnosed as paragonimiasis, tuberculosis in 5 cases, suppurative in 3 cases, 24 cases of etiology. Conclusions The clinical manifestations and hemodynamic changes of CP are similar to those of restrictive cardiomyopathy. The differential diagnosis of CP is still rather difficult. At present, echocardiography is still considered as the most valuable method for the diagnosis of CP. Once diagnosed, early pericardiotomy.