惡性心包膜積液

Malignant Pericardial Effusion

邱楠達(Nan-Ta Chiu) ； 陳如意(Ru-Yih Chen) ； 林素琴(Su-Chyn Lin) ； 黃偉春(Wei-Chun Huang) ； 薛光傑(Kuang-Chieh Hsueh) ； 釋傳琇(Chun-Hsiu Hung)

《安寧療護雜誌》 15卷1期 (2010/03) Pp. 106-116

https://doi.org/10.6537/TJHPC.2010.15(1).8

摘要

心包膜積液可由外傷、心包膜炎、心肌梗塞、惡性腫瘤、藥物等多種因素引起，而惡性腫瘤引起的心包膜積液約佔13至23%。心包膜積液的症狀取決於積水累積的程度，若演變至壓迫心臟影響其正常功能，稱爲心包膜填塞。心包膜積液的臨床診斷包括詳盡的理學檢查，心電圖及抽血檢查，影像學診斷則以超音波爲主。治療除了移除積水，非惡性病人還需治療引起積水的潛在原因。本文回顧對一位末期肺癌合併惡性心包膜積液案例的診斷及治療過期，探討包含胸悶、胸痛、呼吸不順與躁動的相關處置，希望往後對於類似個案，能盡快予以積極的治療，以提昇生活品質。

關鍵字

惡性心包膜積液 ； 心包膜填塞 ； 安寧緩和照護

並列摘要

The probable causes of pericardial effusion include trauma, pericarditis, myocardial infarction, malignancy and drugs, etc. Malignancy induced pericardial effusion accounts for about 13 to 23% of all the reasons. Chest tightness, dyspnea and irritability could be the symptoms of malignant pericardial effusion. The symptom severity depends on the accumulating rate of pericardial fluid. It is called 'cardiac tamponade' if the effusion represses the heart and affects the cardiac ejection function. The clinical diagnosis of pericardial effusion needs explicit physical examination, EKG and biochemical survey. Cardiac sonography is a safe and reliable tool for image diagnosis. Removing the excessive pericardial fluid with adequate drainage can relieve the associated symptoms effectively and improve the quality of life of terminal patient. This article reviews the diagnosis and management of pericardial effusion in a terminal lung cancer patient.

並列關鍵字

malignant pericardial effusion ； cardiac tamponade ； hospice palliative care