尿毒症心包炎的临床研究

Clinical study of uremic pericarditis

本文40例维持性血透尿毒症患者中,心包炎的发生率约为35％.除心包摩擦音外,来见其它特殊临床症状.约50％的患者无任何症状.诊断依靠超声心动图检查.查明患者有无心包积液、心包填塞、心包积液量以及心包炎及范围具有一定价值。该病需加强透析治疗,包括延长透析时间、缩短透析间隔,使用高效、高通透膜,加用血滤及血液灌流,减少肝素用量或改为腹透。本文也讨论了该病的病因.

This article indicated that the incidence of uremic pericarditis was about 35% (earler pericarditis 20%,later pericarditis 15%). No specific clinical manifestations were present in uremic pericarditis,except for pericardial friction rub. About 50% of the patients didn't have any symptoms in our study. The diagnosis was depended on echocardiographic examination. It was of some value in understanding the patients with or without pericardial effusion and cardiac tamponade, the size of effusion and the evolvement of pericarditis. The treatment of uremic pericarditis was intensive dialysis,including prolonging dialysis time,shortening dialysis interval,using high effective-high permeability dialyzer and combination with hemofiltration or hemoperfusion, decreasing heparin dosage or replacement of hemodialysis by peritoneal dialysis. The causes of uremic pericarditis were discussed as well in the prisent paper.