Abstract: The main etiologies of symptomatic massive pericardial effusion are tumor-association,infectivity,iatrogenicity,autoimmune,uremia and idiopathicity.With the relevant guidelines and previous literatures,the paper reviewed the etiology,diagnosis,treatment and prognosis.With the development of diagnostic techniques,programmed diagnosis process combined with dynamic follow-up process,based on medical history,physical and chemical examination of underlying diseases,interventional cardiac-diagnosis techniques,helps improve diagnostic rate of etiology.Currently the treatment principles of symptomatic massive pericardial effusion are mainly dominated by etiological treatment,reasonable and timely pericardial drainage of pericardial effusion to relieve symptoms and reduce the forward incidence rate of constrictive pericarditis.Besides relating to primary disease,the survival prognosis is also related to complications such as early cardiac tamponade,recurrent pericardial effusion,and pericardial constriction.

Key words: Pericardial effusion, Diagnosis, Pericardiocentesis, Prognosis, Review

摘要： 症状性大量心包积液的病因以肿瘤性、感染性、医源性、自身免疫性、尿毒症、特发性为主。本文结合相关指南与既往文献，就症状性大量心包积液的病因、诊断、治疗及预后进行综述。随着诊断技术的发展，以病史、基础疾病理化检查、介入性心包诊断技术为主的程序化诊断流程联合动态随访有助于提高病因学诊断率。目前症状性大量心包积液的处理原则主要以病因治疗、合理及时引流心包积液缓解症状、降低心包缩窄的远期发病率为主，生存预后除与原发疾病相关，也与早期心包填塞、再发心包积液以及远期心包缩窄等并发症密切相关。

关键词: 心包积液, 诊断, 心包穿刺术, 预后, 综述