腹膜透析并发胸腹瘘的诊治进展

发布时间：2018-06-27 15:42

本文选题：腹膜透析 + 胸腹瘘　；参考：《肾脏病与透析肾移植杂志》2017年01期

【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。
[Abstract]:Peritoneal dialysis is a renal replacement therapy for end-stage nephropathy patients. Thoracoabdominal fistula is one of the rare but severe complications in peritoneal dialysis patients. The possible pathogenetic mechanisms include congenital diaphragmatic dysplasia lymphatic drainage and pressure gradient of chest and abdominal cavity. Some of the patients had no obvious clinical symptoms, or had sudden chest tightness, shortness of breath, decreased ultrafiltration and chest pain. The diagnostic methods included abnormal elevated glucose concentration in pleural effusion, methylene blue test or chest X-ray MRI, radionuclide examination, etc. Thoracoabdominal fistula was found in maintenance peritoneal dialysis patients, half of whom need hemodialysis. Therefore, timely and accurate diagnosis of thoracoabdominal fistula is of great significance.
【作者单位】：第四军医大学第一附属医院肾内科;
【分类号】：R692.5

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