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终末期肾衰竭患者的胸腔积液

Pleural Effusion in End Stage Renal Failure Patients.

作者信息

Uzan Gülfidan, İkitimur Hande

机构信息

Department of Chest Diseases, Haseki Training and Research Hospital, İstanbul, Turkey.

Department of Chest Disease, Biruni University, İstanbul, Turkey.

出版信息

Sisli Etfal Hastan Tip Bul. 2019 Mar 19;53(1):54-57. doi: 10.14744/SEMB.2018.40327. eCollection 2019.

Abstract

OBJECTIVES

The aim of this study was to determine the causes of pleural effusion in patients who experienced end-stage renal failure and did not demonstrate any regression of effusion with dialysis treatment.

METHODS

Patients with pleural effusion that did not regress though they attained dry weight with dialysis and those with 2 years of follow-up were included in the study. The mean age of the patients was 48.16±14.5 years. Thirty-five patients were receiving hemodialysis treatment and 8 (18%) were continuous peritoneal dialysis patients. Ascites Ascites (n=6), pleural effusion (n=13), both ascites and pleural effusion (n=5), and pleural effusion that was bilateral (n=22, 51%), right-sided (n=13, 30%), and left-sided (n=8:18%) were detected. According to Light's criteria, the pleural effusion was classified as exudate in 40 (93%) cases and transudate in 3 (7%). Microbiological examination did not identify any pathological agent in any case, and cytological examinations did not reveal atypical cells. The causes of pleural effusion were infection (tuberculosis: n=20, 46%), pneumonia (n=3, 7%), empyema (n=1, 2%), malignancy (lung cancer: n=3, 7%; renal carcinoma: (1, 2%), collagen diseases (n=1, 2%), hepatic abscess (n=1, 2%), pulmonary thromboembolism (n=2, 4%), and idiopathic causes (n=11, 25%).

RESULTS

The causes of pleural effusion were infection (tuberculosis: n=20, 46%), pneumonia (n=3, 7%), empyema (n=1, 2%), malignancy (lung cancer: n=3, 7%; renal carcinoma: n=1, 2%), collagen disease (n=1, 2%), hepatic abscess (n=1, 2%), pulmonary thromboembolism (n=2, 4%), and idiopathic cases (n=11, 25%).

CONCLUSION

Tuberculosis was the most common cause of pleural effusion that did not regress with dialysis treatment.

摘要

目的

本研究旨在确定终末期肾衰竭患者胸腔积液的病因,这些患者的胸腔积液在透析治疗后未出现任何消退。

方法

本研究纳入了尽管通过透析达到干体重但胸腔积液未消退以及有2年随访期的患者。患者的平均年龄为48.16±14.5岁。35例患者接受血液透析治疗,8例(18%)为持续性腹膜透析患者。检测到腹水(n = 6)、胸腔积液(n = 13)、腹水和胸腔积液均有(n = 5)以及双侧胸腔积液(n = 22,51%)、右侧胸腔积液(n = 13,30%)和左侧胸腔积液(n = 8,18%)。根据Light标准,40例(93%)胸腔积液被分类为渗出液,3例(7%)为漏出液。微生物学检查在任何病例中均未发现任何病原体,细胞学检查也未发现非典型细胞。胸腔积液的病因包括感染(结核病:n = 20,46%)、肺炎(n = 3,7%)、脓胸(n = 1,2%)、恶性肿瘤(肺癌:n = 3,7%;肾癌:n = 1,2%)、胶原病(n = 1,2%)、肝脓肿(n = 1,2%)、肺血栓栓塞(n = 2,4%)和特发性病因(n = 11,25%)。

结果

胸腔积液的病因包括感染(结核病:n = 20,46%)、肺炎(n = 3,7%)、脓胸(n = 1,2%)、恶性肿瘤(肺癌:n = 3,7%;肾癌:n = 1,2%)、胶原病(n = 1,2%)、肝脓肿(n = 1,2%)、肺血栓栓塞(n = 2,4%)和特发性病例(n = 11,25%)。

结论

结核病是透析治疗后胸腔积液未消退的最常见原因。

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