摘要
目的探讨腹膜透析患者并发胸腹瘘的临床特点及诊治方法。方法回顾分析2008年1月-2012年12月在该院诊治的4例腹膜透析并发胸腹瘘患者的临床资料,对其临床表现、诊断、治疗及转归进行总结。结果根据临床表现及胸水生化检测对腹透并胸腹瘘患者进行初筛,通过腹透液中加入亚甲蓝或标记放射性核素99mTc-二乙三胺五乙酸(DPTA),引流出蓝色胸水或在胸腔中探测到99mTc-DPTA进行确诊。经抽取胸水、暂停腹透或改行间歇性腹膜透析、胸腔注射高渗糖等治疗方法,3例患者最终转为血液透析,1例继续腹膜透析。结论根据临床表现可早期发现腹膜透析患者的胸腹瘘,用核素扫描法诊断胸腹瘘具有敏感性高、不良反应少的优势;保守治疗无效的胸腹瘘患者如不行胸腔镜或腹腔镜介入治疗较难继续腹膜透析治疗。
[Objective] To study the clinical characteristics, diagnosis and therapy of pleuroperitoneal fisttda in peritoneal dialysis (PD) patients. [Methods] The four PD complicated with pleuroperitoneal fistula cases Who were admitted between Jan of 2008 to Dec of 2012 were analyzed retrospectively, and their clinical manifestations, diagnostic methods, therapies and tumovers in our hospital were summarized. [Results] PD patients complicated with pleuroperitoneal fistula were screened hy ulinical manifestations and pleural biochemical detection; methylene blue or diethylene triaminepentaacetic acid marked ^99mTc (99mTc-DPTA) was infused in the dialysates, four patients were diagnosed hy blue pleural fluid or detecting 99mTc-DPTA in thoracic cavity. Three eases turned to hemodialysis and one ease continued PD with the Iherapy of drawing pleural tluids, quitting PD, using intermittent peritoneal dialysis (IPD)) instead of CAPD. or inlrapleural injeution of hypertonic glucose. [ Conclusion] Pleuroperitoncal fistula can he found early by clinical manifestations, radioisotope seanning has high sensitivity and less side effect to diagnose pleuroperitoneal fistula: if conseryative treatment is invalid for PD patients with pleumperitoneal fistula, they are difficult to continue peritoneal dialysis unless treatment of thoraeoscopie or laparosuopic intervention.
出处
《中国现代医学杂志》
CAS
北大核心
2015年第1期66-69,共4页
China Journal of Modern Medicine
关键词
腹膜透析
胸腹瘘
临床分析
peritoneal dialysis
pleuroperiloneal fistula: clinical analysis