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[腿部水肿]

[Leg edema].

作者信息

Reinhart W H

机构信息

Medizinische Klinik, Kantonsspital Chur.

出版信息

Ther Umsch. 1998 Oct;55(10):624-7.

PMID:9828697
Abstract

The legs are preferentially affected by systemic edematous states. Pathogenetic factors are: increased hydrostatic pressure, increased capillary permeability (leak), reduced colloid-oncotic pressure, reduced lymph drainage and miscellaneous rare conditions. The most frequent cause of increased hydrostatic pressure is right heart failure, which can be treated with diuretic drugs. Increased capillary leak is seen in septic-toxic events, where the underlying disease must be treated. Reduced oncotic pressure is caused by hypoalbuminemia, either due to reduced production, e.g., in liver cirrhosis, or to increased albumin loss, e.g., through the kidney in nephrotic syndrome or the gut in protein-loosing enteropathy. Lymphedema is classified either as primary or secondary and is treated by lymph drainage. Idiopathic edemas, primarily seen in females, often lead to chronic abuse of diuretics, which in turn can cause diuretic-induced edemas.

摘要

双腿是全身性水肿状态的优先受累部位。发病因素包括:静水压升高、毛细血管通透性增加(渗漏)、胶体渗透压降低、淋巴引流减少以及其他罕见情况。静水压升高最常见的原因是右心衰竭,可用利尿剂治疗。毛细血管渗漏增加见于脓毒症 - 中毒事件,必须治疗潜在疾病。胶体渗透压降低由低白蛋白血症引起,其原因要么是白蛋白生成减少,如肝硬化时,要么是白蛋白丢失增加,如肾病综合征时通过肾脏丢失,或蛋白丢失性肠病时通过肠道丢失。淋巴水肿分为原发性或继发性,通过淋巴引流进行治疗。特发性水肿主要见于女性,常导致长期滥用利尿剂,进而可引起利尿剂所致的水肿。

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