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尿毒症性心包炎:30例报告及文献复习

Uremic pericarditis: a report of 30 cases and review of the literature.

作者信息

Sadjadi Seyed-Ali, Mashahdian Ardavan

机构信息

Jerry L. Pettis Memorial Veterans Medical Center, Loma Linda University School of Medicine, Loma Linda, CA, USA.

出版信息

Am J Case Rep. 2015 Mar 22;16:169-73. doi: 10.12659/AJCR.893140.

Abstract

PATIENT

Male, 71 • Male, 69 • . Female, 49.

FINAL DIAGNOSIS

Uremic pericarditis.

SYMPTOMS

MEDICATION

CLINICAL PROCEDURE

Hemodialysis.

SPECIALTY

Nephrology.

OBJECTIVE

Rare disease.

BACKGROUND

Uremic pericarditis, common at one time among dialysis patients, has become a rare entity in recent years. Due to its low incidence, its recognition has gained importance among internists, cardiologists, and nephrologists. It can be seen in predialysis patients and in dialysis patients who are on hemodialysis or peritoneal dialysis.

CASE REPORT

We report 3 cases of uremic pericarditis and their presenting manifestations and review 30 cases we have treated. Among these patients, the traditional findings among patients with acute pericarditis such as chest pain, fever, electrocardiographic changes, and leukocytosis are uncommon. Pericardial friction rub has a relatively high incidence but its differentiation by an untrained ear, especially by a non-cardiologist, could be a major problem. Not infrequently, it is complicated by pre-tamponade or tamponade, requiring pericardiocentesis or pericardial surgery.

CONCLUSIONS

Uremic pericarditis is a treatable, but not always a preventable, condition. Timely recognition of its presence and its efficient management are essential elements of successful treatment.

摘要

患者

男性,71岁 • 男性,69岁 • 女性,49岁。

最终诊断

尿毒症性心包炎。

症状

用药情况

临床操作

血液透析。

专业

肾脏病学。

病例特点

罕见病。

背景

尿毒症性心包炎曾一度在透析患者中较为常见,近年来已成为一种罕见病症。因其发病率低,在内科医生、心脏病专家和肾脏病专家中,对其识别愈发重要。在透析前患者以及接受血液透析或腹膜透析的患者中均可出现。

病例报告

我们报告3例尿毒症性心包炎及其临床表现,并回顾我们已治疗的30例病例。在这些患者中,急性心包炎患者的传统表现,如胸痛、发热、心电图改变和白细胞增多并不常见。心包摩擦音的发生率相对较高,但未经训练的人,尤其是非心脏病专家,辨别心包摩擦音可能是个大问题。它常并发心包填塞前期或心包填塞,需要进行心包穿刺或心包手术。

结论

尿毒症性心包炎是一种可治疗但并非总能预防的病症。及时识别其存在并进行有效管理是成功治疗的关键要素。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5871/4376232/0bc9bd51571c/amjcaserep-16-169-g001.jpg

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