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題名 | Hydrothorax in Peritoneal Dialysis: Case Report and Literature Review=腹膜透析引起的水胸:病例報告及文獻回顧 |
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作者 | 洪麗玉; 洪秋榮; 蔡信宏; Hung, Lie-yee; Hung, Chiu-rung; Tsai, Shin-hung; |
期刊 | 臺灣腎臟醫學會雜誌 |
出版日期 | 20090900 |
卷期 | 23:3 2009.09[民98.09] |
頁次 | 頁171-175+189 |
分類號 | 415.816 |
語文 | eng |
關鍵詞 | 腹膜透析; 水胸; Hydrothorax; Peritoneal dialysis; PD; Video-assisted thoracoscopic surgery; Pleural-fluid-to-serumglucose gradient; |
英文摘要 | Acute hydrothorax secondary to pleuroperitoneal communication is an uncommon but well-recognized complication of peritoneal dialysis (PD). With the increasing use of PD as a replacement therapy in chronic renal failure, the incidence of hydrothorax in PD has also increased. The reported incidence of acute hydrothorax in patients being maintained on peritoneal dialysis varies from 1.6 to 10%. Thoracocentesis with biochemical analysis of pleural fluid is the first-line investigation. The most commonly used biochemical analysis for pleural fluid is pleural-fluid-to-serum-glucose gradient. If diagnosis regarding the biochemical analysis of pleural fluid was uncertain, some imaging approaches including peritoneal scintigraphy, computed tomography (CT) scans and CT peritoneography, magnetic resonance imaging (MRI) and magnetic resonance peritoneography may help clarify the diagnosis. Many different approaches to management of hydrothorax have been reported with varying degrees of success. Treatments often include temporary hemodialysis for 2-6 weeks, then returning to PD with low volume exchanges and on sitting posture. A conservative approach allows reinstitution of PD in 40% of cases. Other therapeutic modalities include chemical pleurodesis, video-assisted thoracoscopic surgery (VATS) with/without pleurodesis, Teflon patch, and partial pleurectomy. There is as yet no consensus on the definitive treatment. We present two such cases and review the related literature. |
本系統之摘要資訊系依該期刊論文摘要之資訊為主。