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持续非卧床腹膜透析开始后不久发现右侧胸腔积液:胸腔镜手术治疗胸膜腹膜瘘。

Right hydrothorax found soon after introduction of continuous ambulatory peritoneal dialysis: thoracoscopic surgery for pleuroperitoneal communication.

作者信息

Hashimoto Makoto, Watanabe Atsushi, Hashiguchi Hitoki, Nakashima Shinji, Higami Tetsuya

机构信息

Department of Cardio-thoracic Surgery, Sapporo Medical University School of Medicine, South 1, West 16, Chuo-ku, Sapporo 060-8543, Japan.

出版信息

Gen Thorac Cardiovasc Surg. 2011 Jul;59(7):499-502. doi: 10.1007/s11748-010-0703-y. Epub 2011 Jul 14.

Abstract

Hydrothorax due to pleuroperitoneal communication is a rare complication in patients undergoing continuous ambulatory peritoneal dialysis (CAPD). One of the problems of this complication is the need to cease CAPD, which means that the patient must shift completely to hemodialysis. Therefore, a quick, minimally invasive, and complete surgical repair of the pleuroperitoneal communication is required. We recently treated a patient who had developed a right hydrothorax soon after the introduction of CAPD. Clinical examination led to a diagnosis of pleuroperitoneal communication. The patient was successfully treated by complete thoracoscopic repair of the communication. We could precisely identify the defective site on the diaphragm using the dye-added CAPD solution method. CAPD was restarted 5 days after the operation, and there was no recurrence of hydrothorax after the operation.

摘要

因胸膜腹膜相通导致的胸腔积液是持续性非卧床腹膜透析(CAPD)患者中一种罕见的并发症。这种并发症的问题之一是需要停止CAPD,这意味着患者必须完全转为血液透析。因此,需要对胸膜腹膜相通进行快速、微创且彻底的手术修复。我们最近治疗了一名在开始CAPD后不久出现右侧胸腔积液的患者。临床检查诊断为胸膜腹膜相通。通过对相通部位进行完全胸腔镜修复,该患者得到了成功治疗。我们使用添加染料的CAPD溶液法能够精确识别膈肌上的缺损部位。术后5天重新开始进行CAPD,术后胸腔积液未复发。

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