摘要
目的 探讨放射性心包炎的诊断和治疗。方法 1982～ 1994年放射治疗的食管中、下段癌 3 5 82例中 2 5例于放射治疗后 18个月至 9年因出现心包积液再入院 ,其中 1例确诊为癌性积液 ,另 2 4例诊断为放射性心包炎 ,予以心包穿刺、激素、抗炎、利尿等治疗。结果 治疗后 2 4例心包积液逐渐消失 ,随访至 2 0 0 1年 9月 ,已死亡 12例 (其中 4例死于缩窄性心包炎 ,4例死于癌转移 ,4例死因不明 ) ,另 12例尚生存中。结论 食管中、下段癌放射治疗对心脏影响较大 ,心包最易受到损伤 ,应尽量减少心脏的受照体积和照射剂量。放射性心包炎应与恶性心包积液鉴别。心包穿刺和激素是治疗放射性心包炎的有效方法 ,缩窄性放射性心包炎应施行心包切除术。
Objective To investigate the diagnosis and treatment of radiation pericarditis. Methods From 1982 to 1994, 3582 patients with esophageal carcinoma in the lower or midthoracic segment received radiotherapy. Twenty-five(0.69%) of them developed pericardial effusion in 1.5 - 9.0 years after radiation. One was carcinomatous effusion, whereas the other 24 patients were diagnosed as having radiation pericarditis and treated with pericardiocentesis,cortical hormone,anti-inflammatory drugs and hydragogue diuresis,and so on.Results With managment,pericardial effusion disappeared gradually in 24 patients. Up to now, 12 patients have died: four of constrictive pericarditis, four of metastasis and another four of unknown reasons.The other 12 patients are still alive.Conclusions Due to the possiblility of developing radiation pericarditis, though rare the area on the heart to be irradiated when giving radiotherapy to middle and lower segment esophageal cancer should be kept minimal. Malignant pericardial effusion should be ruled out by tapping and cytology. Pericardioocentesis,corticosteroids and other conservative management are effective. Pericardiolysis or percardiectomy is indicated when recessary.
出处
《中华放射肿瘤学杂志》
CSCD
北大核心
2003年第B02期56-58,共3页
Chinese Journal of Radiation Oncology
关键词
食管肿瘤
放射疗法
放射性心包炎
Esophageal neoplasms/radiotherapy
Radiation pericarditis
