终末期肾病透析患者阴茎钙化防御：侵袭性治疗和疼痛管理。

Penile calciphylaxis in patients with end-stage kidney disease undergoing dialysis: Invasive treatment and pain management.

机构信息

Artificial Organs, Akane Foundation, Tsuchiya General Hospital, Hiroshima, Japan.

Dermatology, Akane Foundation, Tsuchiya General Hospital, Hiroshima, Japan.

出版信息

Ther Apher Dial. 2022 Oct;26(5):950-959. doi: 10.1111/1744-9987.13789. Epub 2022 Jan 24.

DOI:10.1111/1744-9987.13789

PMID:34984854

Abstract

INTRODUCTION

Penile calciphylaxis is rarely reported in dialysis patients.

METHODS

We experienced cases of dialysis patients who had penile calciphylaxis between 2003 and 2020.

RESULTS

Seven patients undergoing dialysis were treated for penile necrosis (hemodialysis [HD], 5; peritoneal dialysis [PD], 1; hybrid therapy comprising PD and HD, 1). Their mean age was 62.8 years and their mean dialysis vintage 116.1 months. All had severe penile pain and were clinically diagnosed with calciphylaxis. Four received partial penectomy and three received percutaneous transluminal angioplasty (PTA) due to rapid aggravation. The number of analgesia types and the critical-care pain observation tool score significantly decreased after invasive treatment (both, p = 0.008). The 90-day and 1-year survival rates after onset were 85.7% and 57.1%, respectively.

CONCLUSION

In dialysis patients, penile calciphylaxis has poor prognosis; however, invasive treatments for pain management are effective. PTA may be beneficial in dialysis patients in poor condition.

摘要

简介

阴茎钙化性栓塞症在透析患者中很少见。

方法

我们在 2003 年至 2020 年间遇到了几例透析患者发生阴茎钙化性栓塞症的病例。

结果

7 名接受透析治疗的患者因阴茎坏死而接受治疗（血液透析 [HD]，5 例；腹膜透析 [PD]，1 例；PD 和 HD 混合治疗，1 例）。他们的平均年龄为 62.8 岁，平均透析龄为 116.1 个月。所有患者均有严重的阴茎疼痛，并经临床诊断为钙化性栓塞症。由于病情迅速恶化，4 例患者接受了部分阴茎切除术，3 例患者接受了经皮腔内血管成形术（PTA）。侵袭性治疗后，镇痛药物的种类和重症监护疼痛观察工具评分显著减少（均 p = 0.008）。发病后 90 天和 1 年的生存率分别为 85.7%和 57.1%。