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相關文獻
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頁籤選單縮合
題名 | Tuberculous Pericardial Effusion with Intrapericardial Echogenic Masses-- A Case Report=表現心包膜內腫塊之結核性心包膜積水--一病例報告 |
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作者 | 林維祥; 鄭景仁; Lin, Wei-shiang; Jeng, Jing-ren; |
期刊 | Acta Cardiologica Sinica |
出版日期 | 19980400、19980500、19980600 |
卷期 | 14:2 民87.04-06 |
頁次 | 頁87-91 |
分類號 | 415.221 |
語文 | eng |
關鍵詞 | 結核性心包膜炎; 心包膜積水; 心包膜內腫塊; 心臟超音波; 心包膜填塞; Tuberculous pericarditis; Pericardial effusion; Intrapericardial mass; Echocardiography; Cardiac tamponade; |
中文摘要 | 背景:結核性心包膜炎可以造成急性或亞急性心包膜積水,最後形成慢性窄縮性心包膜炎,而在形成結核性心包膜積水的過程中,可能由心臟超音波偵測到一暫時性之心包膜內腫塊。 方法與結果:一位二十七歲男性病患,因持續兩週之運動性氣促及輕度發燒來院求診,心臟超音波發現有大量心包膜積水,右心房舒張性塌陷及心包膜內高回音性腫塊,心包膜放液檢查發現存出血性心包膜積水,而且以淋巴球成份居多.最後由心包膜切片檢查,確定為結核性心包膜炎,在接分心包膜放液術及抗結核藥物治療後,心包膜積水及腫塊便消失,五個月後心臟超音波檢查,亦未見復發。 結論:在結核性心包膜炎引起的亞急性心包膜積水及心包膜填塞的病人藉心臟超音波檢查觀察到心包膜內腫塊,這些腫塊可經由心包膜放液術及抗結核藥物治療後消失,其成份被認為是一種纖維性滲出物的聚合體,因此,在考慮心包膜內腫塊的原因時,勿忘將結核性心包膜炎列入鑑別診斷。 |
英文摘要 | Background: Patients with tuberculous (TB) pericarditis may present with acute or subacute pericardial effusion and develop chronic constrictive pericarditis. A transient intrapericardial mass can be detected by echocardiography during the course of TB pericardial effusion. Methods and Results: A 27-year-old male patient was admitted, having suffered from progressive dyspnea and low grade fever for two weeks. The echocardiographic examination showed massive pericardial effusion, diastolic right atrium collapse and multiple band-like echogenic masses in the intrapericardial cavity. Pericardiocentesis disclosed a hemorrhagic pericardial effusion with lymphocytosis. The pathology report of the pericardial biopsy supported the diagnosis of TB pericarditis. The intrapericardial echogenic masses were no longer detected by echocardiography after anti-TB chemotherapy for five months. Conclusion: Intrapericardial echogenic masses were observed in a young patient with TB pericarditis presenting with subacute pericardial effusion and cardiac tamponade. The complete resolution of the masses after pericardiocentesis and anti-TB treatment suggested that it was a conglomeration of fibrinous exudates deposited in the pericardial cavity. Hence, TB pericarditis should be considered as one of the differential diagnose for intrapericardial echogenic mass. |
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