The choice of ultrasound-guided pericardiocentesis route for percutaneous indwelling catheter drainage in patients of ma-lignant disease with pericardial effusion

BI Mingsen; CAO Junying; ZHANG Yun; LI Ziyu; GAO Yue; WANG Xue; LU Chao

Abstract：Objective To study the advantage of ultrasound-guided pericardiocentesis route for percutaneous indwelling cathe-ter drainage in patients of malignant disease with pericardial effusion via apex of heart. Methods In the 90 patients with moder-ate or large pericardial effusion,the pericardial echo-free space was measured with two-dimensinal echocardiolgraphy prior to peri-cardiocentesis in three sites:apex of heart,subxiphoid and the left sternal broader in the third or fouth interspace. Under the guid-ance of ultrasound Cook catheters were percutaneously indwelled for pericardial drainage via the location of apex of heart with pa-tients in semireclining position. Results In the 30 patients with moderate pericardial effusion, the pericardial echo-free space of apex of heart and subxiphoid in semireclining position was larger than that in clinostatism and there was significant significance in them ( P <0. 05). In the 60 patients with large pericardial effusion, the pericardial echo-free space of apex of heart in semire-clining position was larger than that in clinostatism, and there was a significant significance in them ( P <0. 05). The pericardial echo-free space in semireclining position was the largest. The procedures of indwelling catheter drainage for pericardial effusion were successfully performed in all the 90 patients. Pericardio-centesis route via apex of heart was more easily in paralled with myo-cardium. Conclusion Ultrasound-guided pericardiocentesis route for percutaneous indwelling catheter drainage in patients of ma-lignant disease with pericardial effusion via apex of heart is safer and more efficient. It is easer to do it and relieves patients' pain.