首页|维持性血液透析患者血性心包积液一例并文献复习

维持性血液透析患者血性心包积液一例并文献复习

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心包积液是尿毒症患者的一种常见并发症,通常与尿毒症毒素蓄积、低蛋白血症及心力衰竭相关。在多数情况下,加强透析、调整干体质量和补充白蛋白等治疗方法可以有效减轻积液。然而,本文报道了一例维持性血液透析患者,因反复出现大量血性心包积液,经常规治疗后积液量无明显减少;反复痰培养检出分枝杆菌后患者接受抗结核治疗,心包积液显著减少。此病例提示,在难治性心包积液中应考虑潜在的结核感染因素。
Hemorrhagic pericardial effusion in a patient undergoing maintenance hemodialysis:a case report and literature review
Pericardial effusion is a common complication in uremic patients,typically associated with the accumu-lation of uremic toxins,hypoproteinemia,and heart failure.In most cases,pericardial effusion can be effectively reduced through enhanced dialysis,dry weight adjustment,and albumin supplementation.However,this paper reports a patient un-dergoing maintenance hemodialysis who repeatedly developed large amounts of hemorrhagic pericardial effusion and had no significant reduction in the effusion volume after conventional treatment.Mycobacterium tuberculosis was identified in the patient after repeated sputum culture,and the pericardial effusion was notably reduced following anti-tuberculosis thera-py.This case highlights the need to consider potential tuberculosis infection in refractory pericardial effusion.

HemodialysisHemorrhagic pericardial effusionPhlegmMycobacteriumAnti-tuberculosis therapy

陈荣、宋海英、万启军

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深圳市大鹏新区葵涌人民医院肾内科,广东 深圳 518119

深圳市第二人民医院肾内科,广东 深圳 518035

血液透析 血性心包积液 分枝杆菌 抗结核治疗

2025

海南医学
海南省医学会

海南医学

影响因子:1.158
ISSN:1003-6350
年,卷(期):2025.36(1)