Nomoto Y, Suga T, Nakajima K, Sakai H, Osawa G, Ota K, Kawaguchi Y, Sakai T, Sakai S, Shibata M
Department of Internal Medicine, School of Medicine, Tokai University, Isehara, Japan.
Am J Nephrol. 1989;9(5):363-7. doi: 10.1159/000167997.
Follow-up studies on 3,195 patients from 161 centers in Japan undergoing continuous ambulatory peritoneal dialysis (CAPD) were performed for 1-104 months to clarify the incidence as well as the clinical features of acute hydrothorax. In these studies, 50 patients (1.6%) developed this complication. Twenty-seven (54%) were men, and 23 (46%) were women, ranging in age from 6 to 79 (average 49) years. The interval between onset of CAPD and hydrothorax ranged from 1 day to 8 years. Four had left-sided, and 2 had bilateral hydrothorax, but the majority (88%) were right-sided. Dyspnea was experienced by 37 of these 50 patients, but the remaining 13 (26%) patients were asymptomatic. Hydrothorax was fully resolved in 27 of them following a brief interruption of CAPD or the combined use of small exchange volumes in a semi-sitting position and pleurodesis with tetracycline or other agents. The remaining 23 patients (46%) were switched to hemodialysis permanently. Despite recurrence, 1 patient continued successfully on CAPD. It was concluded that acute hydrothorax is one important possible complication, although the risk may be low. Constant surveillance is necessary to detect pleural effusions in patients during CAPD.
对来自日本161个中心的3195例接受持续性非卧床腹膜透析（CAPD）的患者进行了为期1至104个月的随访研究，以明确急性胸腔积液的发生率及其临床特征。在这些研究中，50例患者（1.6%）出现了这种并发症。其中27例（54%）为男性，23例（46%）为女性，年龄在6至79岁之间（平均49岁）。CAPD开始至胸腔积液出现的间隔时间为1天至8年。4例为左侧胸腔积液，2例为双侧胸腔积液，但大多数（88%）为右侧胸腔积液。这50例患者中有37例出现呼吸困难，但其余13例（26%）患者无症状。其中27例在短暂中断CAPD或半卧位使用小交换量并联合四环素或其他药物进行胸膜固定术后胸腔积液完全消退。其余23例患者（46%）永久转为血液透析。尽管有复发情况，1例患者仍成功继续进行CAPD治疗。得出的结论是，急性胸腔积液是一种重要的可能并发症，尽管风险可能较低。在CAPD患者中持续监测以检测胸腔积液是必要的。
