ISSN 1006-298X      CN 32-1425/R

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肾脏病与透析肾移植杂志 ›› 2017, Vol. 26 ›› Issue (1): 81-84.DOI: 10.3969/cndt.j.issn.1006-298X.2017.01.018

• 论文 • 上一篇    下一篇

腹膜透析并发胸腹瘘的诊治进展

  

  • 出版日期:2017-02-28 发布日期:2017-02-21

Peritoneal dialysis related hydrothorax:diagnosis,treatment and management

  • Online:2017-02-28 Published:2017-02-21

摘要:

腹膜透析是终末期肾病患者的肾脏替代治疗方法之。胸腹瘘是腹膜透析患者少见但严重的并发症之一,可能的致病机制包括先天性横膈发育异常、淋巴引流和胸腹腔压力梯度。部分患者无明显临床症状,或突然出现胸闷、气短,超滤量下降及胸痛,诊断方法包括胸水中异常增高的葡萄糖浓度、亚甲蓝实验或者X线胸片、CT、MRI、放射性核素检查等。维持性腹膜透析患者出现胸腹瘘,半数需改为血液透析。因此,及时准确地诊断胸腹瘘有重要意义。

关键词: 腹膜透析, 胸腹瘘, 诊断, 治疗

Abstract:

Peritoneal dialysis (PD) is an effective treatment option for patients with endstage renal disease.Hydrothorax occurs in 16%~6% of patients who undergo Continuous Ambulatory Peritoneal Dialysis(CAPD),and approximately half of these patients are forced to permanently exchange CAPD for haemodialysis.Possible pathogenetic mechanisms include congenital diaphragmatic defects,a disorder of lymphatic drainage,and pleuroperitoneal pressure gradient.Usually,the patients may remain asymptomatic or have sudden dyspnea,decrease in ultrafiltration,or pleuritic chest pain. Effective diagnostic methods,includeing high glucose concentration of the pleural fluid,chest radiograph,CT,MRI,peritoneogram with Tc99mMAA,are useful to diagnose hydrothorax.Searching for a simple and valid way to treatment pleural leakage has become particularly important.