Division of Renal Diseases and Hypertension, Department of Medicine, George Washington University, Washington, DC 20037, USA.
Perit Dial Int. 2010 Jan-Feb;30(1):13-8. doi: 10.3747/pdi.2008.00168.
Hydrothorax in a patient treated with peritoneal dialysis (PD) poses a diagnostic dilemma. Hydrothorax due to migration of dialysis fluid across the diaphragm and into the pleural space creates a serious complication of PD but generally does not threaten life. Shortness of breath causes the patient to seek medical attention. A sudden diminution in dialysis adequacy or poor ultrafiltration rate constitutes a unique marker for patients treated with PD compared to the general population. This article reviews the etiology for hydrothorax specifically in the PD population. Thoracentesis with chemical analysis of the fluid, imaging studies with and without contrast or markers, and video-assisted thoracoscopic surgery play important roles in the evaluation of hydrothorax. A conservative PD regimen, surgical intervention, and pleurodesis provide treatment options to those receiving PD.
在接受腹膜透析 (PD) 治疗的患者中出现胸腔积液会带来诊断上的困境。由于透析液穿过横膈膜进入胸腔而导致的胸腔积液是 PD 的严重并发症，但通常不会威胁生命。呼吸困难导致患者寻求医疗救治。与一般人群相比，透析充分性突然降低或超滤率不佳是 PD 患者的一个独特标志。本文专门综述了 PD 患者胸腔积液的病因。胸腔穿刺并对积液进行化学分析、有或无对比剂或标志物的影像学检查以及电视辅助胸腔镜手术在胸腔积液的评估中发挥着重要作用。对于接受 PD 治疗的患者，可选择保守的 PD 方案、手术干预和胸膜固定术等治疗方法。
