D'Amato Rossella, Eiroa González Luisa E, Hernández Méndez Ana Isabel
Pneumology Department, Hospital Universitario Nuestra Senora de la Candelaria, Santa Cruz de Tenerife, Spain.
BMJ Case Rep. 2017 Jan 9;2017:bcr2016218286. doi: 10.1136/bcr-2016-218286.
A 68-year-old man with alcoholic liver cirrhosis and portal hypertension was admitted due to ascites. Bilateral severe hepatic hydrothorax did not resolve despite sodium restriction, and diuretic treatment, requiring repeated thoracentesis for relief of dyspnoea. Curative options, as transjugular intrahepatic portosystemic shunt and liver transplantation were both contraindicated. An attempt of pleurodesis was ineffective. Bilateral insertion of tunnelled pleural catheter allowed symptom control and home discharge. After 6 months, bilateral stable pleurodesis has been achieved and patient is still free from dyspnoea.
一名68岁患有酒精性肝硬化和门静脉高压症的男性因腹水入院。尽管限制了钠摄入并进行了利尿治疗,但双侧严重肝性胸水仍未消退,需要反复进行胸腔穿刺以缓解呼吸困难。经颈静脉肝内门体分流术和肝移植等治疗选择均为禁忌。胸膜固定术的尝试未取得成效。双侧置入带隧道的胸膜导管实现了症状控制,患者得以出院回家。6个月后,双侧实现了稳定的胸膜固定,患者仍无呼吸困难症状。