Townsend R, Fragola J A
Arch Intern Med. 1982 Aug;142(8):1571-2.
A 51-year-old woman had end-stage renal failure from polycystic kidney disease. Two years after she started receiving peritoneal dialysis, a large right pleural effusion developed in the patient that was secondary to a pleuroperitoneal connection as demonstrated by a radionuclide scan. The patient was switched from continuous ambulatory peritoneal dialysis (CAPD) to intermittent peritoneal dialysis (IPD) with resolution of the effusion that recurred when she was rechallenged with CAPD one month later. We believe the large ultrafiltrate volume of CAPD with prolonged dwelling times may have ruptured microscopic defects in the diaphragm due to increased abdominal pressure. With the smaller ultrafiltrate volume of IPD and the semisitting position, the patient was able to continue receiving peritoneal dialysis with resolution of the pleural effusion.
一名51岁女性因多囊肾病发展至终末期肾衰竭。在开始接受腹膜透析两年后，该患者出现大量右侧胸腔积液，放射性核素扫描显示这是由胸膜腹膜连接所致。患者从持续性非卧床腹膜透析（CAPD）改为间歇性腹膜透析（IPD）后，胸腔积液消退，而在一个月后重新采用CAPD时积液复发。我们认为，CAPD超滤量大且停留时间长，可能因腹压增加导致膈肌微小缺损破裂。由于IPD超滤量较小且患者处于半坐位，患者得以继续接受腹膜透析，胸腔积液也得以消退。
