心包积液课件_1.ppt

PERICARDIAL EFFUSION (心包积液) Pericardial Effusion Pericardial effusion may develop as a resp-onse to injury of the parietal(壁层的) pericardium with all cases of acute pericarditis. ? 心包积液可出现于所有急性心包炎中，为壁层心包受损的反应。 Pericardial Effusion It may be clinically silent, but if the accum-ulation of fluid causes intrapericardial pres-sure to increase,resulting in cardiac comp-ression,the symptoms of cardiac tamponade develop. 临床上可无症状，但如果液体积聚导致心包腔内压升高而产生心脏压迫则可出现心脏压塞。 Pericardial Effusion The development of increased intrapericardial pressure secondary to pericardial effusion depends on several factors: ①The absolute volume of the effusion, ②The rate of fluid accumulation, and ③The physical characteristics of the pericardium itself. 继发于心包积液的心包腔内压升高与以下几个因素有关：①绝对的积液量；②积液产生的速度；③心包本身的特性。 Pericardial Effusion The pericardical space in humans normally contains between 15 and 50 ml of fluid.If additional fluid accumulates slowly, the pericardium stretches; the pericardial sac can accommodate up to 2 liters without elevation of intrapericardial pressure. 正常人心包腔容纳15-50ml液体，如液体积聚缓慢，心包伸展，心包腔内可适应多达2升液体而不出现心包腔内压升高。 Pericardial Effusion If additional fluid is rapidly added to a volume exceeding about 150 to 200 ml, a marked rise of intrapericardial pressure occurs. 如液体迅速增加超过150-200ml，则心包腔内压会显著上升。 Pericardial Effusion Without Cardiac Compression(不伴心脏压塞的心包积液) History(病史). Patients who develop pericardial effusion without elevation of intrapericardial press-ure may have no symptoms whatsoever. 有心包积液但没有心包腔内压升高的患者可以没有任何症状。 History Occasionally these patients complain of a constant oppressive dull ache or pressure in the chest. 偶尔这些病人会主诉有持续性的胸部压迫性钝痛或压迫感。 History Large pericardial effusions may cause symptoms by mechanical compression of adjacent structures, including dysphagia from esophageal compression, cough due to bronchial/tracheal compression, 大量心包积液则可因邻近组织机械性受压而产生症状。包括食管受压引起吞咽困难，气管、支气管