It turns out that there are four treatments for acute suppurative pericarditis

Acute suppurative pericarditis is mostly caused by direct contamination of the pericardium due to trauma. Most patients are children or teenagers. It poses a huge threat to human health. Therefore, it is particularly important to understand the treatments for acute suppurative pericarditis. In fact, there are four ways to treat acute suppurative pericarditis. The first one is systemic treatment.

(1) Systemic treatment: Administer sufficient doses of effective antibiotics intravenously for antibacterial treatment. At the same time, strengthen systemic support, transfuse fresh blood in small amounts and multiple times, eat a high-protein, high-vitamin diet, maintain electrolyte balance, and perform physical cooling when necessary.

(2) Pericardiocentesis: It is suitable for draining pus and injecting antibiotics into the pericardial cavity in the early stage of the disease when the exudate is still thin. Depending on the amount of effusion, the subxiphoid approach or the parasternal approach can be selected for puncture. Pus was drained and antibiotics were injected each time. For safety, the puncture can be performed under electrocardiogram monitoring, that is, the puncture needle is connected to the chest lead exploration electrode. When the needle tip touches the myocardium, a reverse QRS wave group appears on the electrocardiogram. If conditions permit, it can also be performed under ultrasound monitoring.

(3) Pericardiotomy and drainage: Suitable for patients whose condition has not improved significantly after repeated pericardiocentesis. The operation can be performed under local anesthesia by removing the fifth or sixth costal cartilage on the left side, ligating and cutting the internal mammary artery, opening the pericardium through the costal cartilage bed, clearing the pus in the pericardium, and flushing with warm saline. The cut edge of the pericardium is sutured to the chest wall incision, and a rubber sheet can be placed in the pericardium for drainage. Warm saline can be used for flushing and antibiotics can be inserted during daily dressing changes after surgery.

(4) Partial pericardiectomy: Suitable for patients with long-term illness who have developed chronic constrictive pericarditis.

For diagnostic tests:

X-ray: shows signs of pericardial effusion, flask-like cardiac shadow, disappearance of cardiac edges, weakened cardiac beat, etc.

Electrocardiogram: All leads showed low voltage QRS wave group, ST segment elevation in standard limb leads, and inverted T wave.

Echocardiogram: reflected waves from a large amount of fluid in the pericardial cavity.

Pericardiocentesis: The diagnosis can be made by extracting purulent fluid, and the punctured material can be sent for smear and bacterial culture to identify the causative bacteria.