Using of new minimally invasive procedures in diagnostic, treatment and prevention of acute pericarditis
Keywords:pericardioscopy, pericarditis, puncture, pericardium, exudate, constrictions, diagnostic, treatment, micro drainage, pathognomonic treatment
This study proves satisfactorily the effectiveness of using two new methods of minimally invasive procedures for possibility of accurate diagnosis, appropriative and intense medical treatment of acute pericarditis in long term period.
Aim – presentation of two new methods of minimally invasive procedures, which are performed with pericardioscopy and are assigned for effective diagnostic and treatment of pericarditis: introducing of micro drainage into pericardium; Performing pericardioscopy with following drainage using pericardioscope without using large discission.
Materials and methods. This study includes results of 571 patients with acute pericarditis diagnosed since 1990 till 2014. Due to the etiology of pericarditis all the patients were divided into six groups: Viral, Bacterial, Tuberculous, Autologous-Reactive, Uremic, Tumoral. Main group included patient with viral acute pericarditis. Study includes 339 males and 232 females. Male’s main group was with viral pericarditis, female’s – patients with autologous-reactive acute pericarditis.
In this study were used: assessment of clinical signs, ECG, chest X-Ray, echocardiogram, pericardium puncture, pericardiocentesis.
Results. Results of using both methods are presented in clinical case, which illustrates opportunities of accurate diagnosis, appropriative and intense medical treatment of acute pericarditis. In 11-years follow-up patient has no clinically significant changes in chest organs, no exacerbations were diagnosed, thus, the effectiveness of proposed method for long-term period was proved.
Conclusion. 1. Using of the method «Introducing of micro drainage into pericardium», allows to determine diagnosis during 24 hours in 90% of all cases, to prevent complications related to acute pericarditis and in some ways to neutralize the acute condition of the disease.
2. In case when diagnosis is not verified in 48 hour another method is used: «Performing pericardioscopy with following drainage using pericardioscope without using large discission». This minimally invasive procedure allows performing qualitative video review; perform biopsy, and make appropriate analysis of material received, which will inform about injury level of pericardium to start accurate pathognomonic treatment.
3. Using of both methods reduces hospitalization, prevent serious constrictive complications in long-term period.
4. Accurate, starred in time treatment of acute process in pericardium prevent pericardium fibrosis – complete cure.
5. Only cardio therapeutic treatment is not effective for treatment of acute pericarditis, these patients have to be hospitalized and treated by thoracic surgeon or cardio surgeon
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