Partial pericardectomy for acute suppurative pericarditis

Acute suppurative pericarditis is an acute inflammation caused by pathogenic bacteria invading the pericardium. The pathogens are usually Staphylococcus aureus, Streptococcus, Streptococcus pneumoniae, Meningococcus, and Hemophilus influenza. Less common pathogens include Pseudomonas aeruginosa, Escherichia coli, Proteus, and Salmonella. Other pathogens such as amoeba, actinomycetes, and coccidioidos can also be caused. In China, it is more common to cause Staphylococcus aureus. After acute infection of the pericardium, the serosa layer is congested and edema, a large amount of leukocyte infiltration and serous cellulose exudate, accumulating in the pericardial cavity. Since the pericardium is composed of fibrous connective tissue, its stretch is limited. When the inflammatory exudate grows too fast, the pressure in the pericardial cavity can suddenly increase, and the heart, especially the right heart system, is forced to be blocked, the blood flow to the heart is blocked, the blood output is reduced, and the blood pressure is lowered, causing the heart. Pressure plug. If you do not puncture or drain the decompression in time, you can quickly endanger the patient's life. Treating diseases: pericarditis Indication Pericardial partial resection for acute suppurative pericarditis applies to: 1, acute suppurative pericarditis a large amount of pus formation with cardiac tamponade, puncture treatment is invalid. 2, the pus is sticky, forming a separation in the pericardial cavity. 3, severe symptoms of poisoning, pericardial puncture and drug treatment without significant effect. Preoperative preparation A large number of broad-spectrum antibiotics are used to prevent the spread of infection. And actively support therapy to improve the general condition. Patients with obvious cardiac tamponade should undergo pericardial puncture to relieve symptoms and increase tolerance to anesthesia and surgery. Surgical procedure 1. The 4th intercostal space of the left intercostal space is inserted into the chest. 2. Cut the happy bag in front of the left phrenic nerve. Release the pus, separate the cellulosic adhesions in the pericardium, remove the necrotic material and the pus moss adhering to the surface of the heart, repeatedly wash the pericardial cavity with saline repeatedly, and then partially remove the pericardium, and reach the left and right phrenic nerves on both sides. To the aorta and the roots of the pulmonary artery. 3, the pericardial resection of the wound edge needs to be electrocoagulated to stop bleeding, the left chest is placed in the drainage tube, layered to close the chest.

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