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相關文獻
- Multiple Diaphragmatic Defects Complicated with Acute Hydrothorax in a Peritoneal Dialysis Patient--A Case Report
- Peritoneal Scintigraphy for the Assessment of Dialysate Leakage in Patients on Continuous Ambulatory Peritoneal Dialysis
- 腹膜透析病患併發水胸之回溯分析
- Video-assisted Thoracoscopic Surgery with Direct Suture and Pleurodesis for Diaphragmatic Defect in Patients on Continuous Ambulatory Peritoneal Dialysis--A Case Report
- Diagnosis of Peritoneopleural Communication with [fee6]Tc-MAA Scintigraphy in a Patient with Continuous Ambulatory Peritoneal Dialysis: A Case Report and Literature Review
- Hydrothorax in Peritoneal Dialysis: Case Report and Literature Review
- Video-Assisted Thoracoscopic Surgery for Peritoneal Dialysis-related Hydrothorax
- 腹膜透析併發再發性腹膜炎
- 連續可活動性腹膜透析自我效力量表之建立與測試
- 腹膜透析處方之臨床實用準則
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| 題 名 | Multiple Diaphragmatic Defects Complicated with Acute Hydrothorax in a Peritoneal Dialysis Patient--A Case Report=腹膜透析患者併發橫膈缺損及急性水胸--病例報告 |
|---|---|
| 作 者 | 陳煥威; 林楷煌; 劉小華; 陳皇吉; | 書刊名 | 胸腔醫學 |
| 卷 期 | 30:5 2015.10[民104.10] |
| 頁 次 | 頁314-320 |
| 分類號 | 415.816 |
| 關鍵詞 | 水胸; 胸腔腹腔交通; 腹膜透析; Hydrothorax; Pleuro-peritoneal communication; Peritoneal dialysis; |
| 語 文 | 英文(English) |
| 中文摘要 | 腹膜透析是末期腎病的患者,在接受腎臟替代療法中的一種選擇,目前來說確實愈來愈被廣為使用。在所有與腹膜透析相關的併發症中,水胸這個併發症的發生比例相對較低,而且這個疾病也有其特殊的表現。我們所提的這個病例報告是一位 51歲因為末期腎病而接受腹膜透析的女性患者,她就醫主要的問題是一個禮拜的乾咳以及愈來愈厲害的呼吸喘促。胸部 X光顯示有大量的右側肋膜積液,而且肋膜積液的分析顯示出有高的葡萄糖含量。我們安排腹部的鎝 -99m閃爍攝影檢查,發現在右邊肺野的放射線活性增高,顯然有胸腔腹腔交通的問題存在。影像輔助的胸腔內視鏡檢查發現有多處橫膈缺損,因此接著做內視鏡橫膈修補。之後,這個患者將她的腎臟替代療法改為血液透析,也不再有水胸的這個問題復發。針對這樣一個腹膜透析相關的水胸,生化和影像方面的檢查都有助於診斷的確立。而且影像輔助的胸腔內視鏡檢查合併內視鏡修補,理應是一個適當的治療選項。 |
| 英文摘要 | Peritoneal dialysis, a renal replacement therapy, is being increasingly used for patients with end-stage renal disease. Of all the complications related to peritoneal dialysis, hydrothorax is rather less common. Hydrothorax related to peritoneal dialysis has its unique presentation. We report a 51-year-old woman who received peritoneal dialysis for her end-stage renal disease and presented to our hospital with non-productive cough and progressive deteriorated shortness of breath for 1 week. The chest X-ray showed a massive amount of right-side pleural effusion, and the pleural fluid analysis revealed it was transudative with a high glucose content. We arranged peritoneal scintigraphy with a technetium-99m Phytate shunt scan and the result showed increased activity in the right lung field, suggestive of the existence of pleuro-peritoneal communication. Video-assisted thoracoscopy was arranged, and showed multiple diaphragmatic defects. Surgical diaphragmatic repair was then performed with endoscopic suture. Thereafter, the patient changed her renal replacement therapy to hemodialysis. No recurrent hydrothorax was found in the subsequent follow-up course. For the diagnosis of hydrothorax related to peritoneal dialysis, biochemistry and imaging studies are indicated, and video-assisted thoracoscopy with endoscopic suture would be a reasonable treatment choice. |
本系統中英文摘要資訊取自各篇刊載內容。