醫學五：80題 ( 包括外科,骨科,泌尿科等科目及其相關臨床實例與醫學倫理 )題庫下載題庫

(治療)
治療原則包括儘早清除積液以解除心臟壓迫。一般而言，急性心包積液在100ml即可出現填塞症狀，故在緊急狀況下可先作心包腔穿刺(pericardiocentesis)。

心包斜竇是心包積液最多部位，在超音波引導下，在劍突與左肋弓緣交界處進針或左第5 肋間之心濁音界內側1～2 cm處進針(the insertion of a needle through the skin and into the pericardium and aspirating fluid under ultrasound guidance preferably. This can be done laterally through the intercostal spaces, usually the fifth, or as a subxiphoid approach)。然而，急性心包填塞，最有效治療方式是心包切開、引流，修補心臟出血或破損處(Following stabilization of the patient, surgery is provided to seal the source of the bleed and mend the pericardium)。其他輔助治療包括輸血、輸液擴充血液容量，積極的治療可以預防休克、心肌梗塞、心律不整、心臟衰竭、室壁瘤心臟破裂或血栓形成，提高存活率。(If aggressive treatment is offered immediately and no complications arise(ex. shock, AMI or arrhythmia, heart failure, aneurysm, embolism, or rupture)。