摘要

Two cases of right hepatic hydrothorax occurring in the absence of clinical ascites are reported. Diagnosis was confirmed by the intraperitoneal and intrapleural injection of radioisotope 99mTc-sulfur colloid that demonstrated the one-way transdiaphragmatic flow of fluid from the peritoneal to pleural cavities. In contrast, radioisotope injected into the peritoneal cavity of 5 patients with pleural effusions secondary to pulmonary or cardiac disease failed to traverse the diaphragm and localize in the pleural space. Medical therapy with salt and water restriction and diuretics resulted in both of the patients with hepatic hydrothorax developing signs of intravascular volume depletion without significant mobilization of the pleural fluid. Thoracotomy allowed identification of the diaphragmatic defects that were repaired by chemical and traumatic pleurodesis followed by postoperative peritoneal and pleural drainage. This therapy resulted in complete resolution of the pleural effusions, which have not recurred despite the subsequent development of clinical ascites in both patients.

译文

报告了两例右肝性胸水发生在没有临床腹水的情况下。通过腹腔和胸腔内注射放射性同位素 99mtc-硫胶体证实了诊断,表明了液体从腹膜到胸膜腔的单向跨膈肌流动。相比之下,5 名继发于肺部或心脏疾病的胸水患者腹腔注射的放射性同位素未能穿过隔膜并定位于胸膜间隙。限制盐和水的药物治疗和利尿剂导致两个肝性胸水患者出现血管内容量耗尽的迹象,而没有明显调动胸水。开胸手术可以识别经化学和创伤性胸膜固定修复的膈肌缺损,然后进行术后腹腔和胸腔引流。这种疗法导致胸水完全消退,尽管两名患者随后都出现了临床腹水,但胸水并未复发。

hydrothorax

呼吸 胸膜腔内液体形成过快或吸收过缓 疾病
概述  :  

疾病概述胸膜腔是位于肺和胸壁之间的一个潜在的腔隙。在正常情况下脏层胸膜和壁层胸膜表面上有一层很薄的液体,在呼吸运动时起润滑作用。胸膜腔和其中的液体并非处于静止状态,在每一次呼吸周期中胸膜腔的形状和压力均有很大变化,使胸膜腔液体持续滤出和吸收并处于动态平衡,任何因素使胸膜腔内液体形成过快或吸收过缓,即产生胸腔积液(简称胸水)。 病因及病理机制胸腔积液是常见的内科问题,肺,胸膜和肺外疾病均可引起,临床上常见的病因和发病机制如下所述。(一)胸膜毛细血管内静水压增高:如充血性心力衰、缩窄性心包

hydrothorax   英 /,haɪdrə(ʊ)'θɔːræks/   美 /,haɪdrə'θoræks/ 

释    义   n. [内科] 胸膜积水,[内科] 水胸

例    句   To investigate the value of ADA in differential diagnosis of hydrothorax. 探讨腺苷脱氨酶活性测定在胸腔积液鉴别中的应用。

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