X线平片动态观察慢性肾功能衰竭血液透析前后的心胸表现  

Dynamic Observation of The Manifestation on X-ray Chest Films in Chronic Renal Failure Patients Before and After Haemodialysis

作　　者：王巧兮[1] 刘晋新[1] 陈孟荣[1] 李茂进[1] 代美英 陈喜兰[1] 林怡蔼[1] 

机构地区：[1]湖北医科大学第一临床学院放射科

出　　处：《临床放射学杂志》1997年第6期342-344,共3页Journal of Clinical Radiology

摘　　要：目的：对３９例慢性肾功能衰竭（ＣＲＦ）尿毒症患者心胸异常Ｘ线改变者血液透析（ＨＤ）前后Ｘ线平片动态观察，以评价血液透析疗效。材料与方法：本组３９例ＣＲＦ尿毒症患者经摄胸片发现心胸异常Ｘ线改变的病例作ＨＤ前后对照；包括ＨＤ前后摄全胸Ｘ线平片测血管蒂宽度（ＶＰＷ）及查血液中代谢毒素Ｂｕｎ、Ｓｃｒ含量作比较。结果：３９例于血液透析前Ｂｕｎ和Ｓｃｒ值均高度升高，透析后有明显降低，前后对照于统计学有显著差异（Ｐ＜０．０１），症状改善亦甚明显。透析前胸部Ｘ线照片发现肺水肿２９例，透析后２６例吸收；肺水肿并心衰２例透析后均好转；胸腔积液２８例于透析后１９例吸收；尿毒症心肌和心包病变３０例，透析后２６例心影缩小。ＶＰＷ于透析后亦较术前有显著缩小（Ｐ＜０．０１）。结论：胸部Ｘ线表现与Ｂｕｎ、Ｓｃｒ于透析前后作比较，有同步的好转。说明胸部Ｘ线平片动态观察尿毒症能客观反映血液透析前后的病理生理改变，为评价血液透析疗效的主要方法之一。Objective: Thirtynine cases of uremic patients under chronic renal failure (CRF) all have abnormal appearance on the chest x-ray films. X-ray manifestations of these patients in pre and post-dialysis may evaluate the effect of haemodialysis (HD).Materials and Methods:In 39 CRF patients the radiologic signs of uremia on the chest films and the contents of Bun and Scr in the blood were compared before and after HD. The relation between both results was analysed.Results:The blood contents of Bun and Scr in all these patients were very high before HD, but decreased to nearly normal after HD, and [WT5”BX〗t test between them showed significance (P<0.01). Manifestations of pulmonary edema in 29 cases on Xray films before HD 26 have subsided after HD. In the similar manner 2 cases of pulmonary edema with cardiac failure relieved, 19 cases of pleural effusion were absorbed, heart shadow of myocarditis and pericarditis in 19/30 cases reduced, and the average vascular pedicle width decreased obviously after dialysis.Conclusion: The dynamic observation of the manifestations on X-ray chest films was the same as the blood Bun and Scr, and could reflect the patho-physiological change and evaluate the effect of HD in CRF patients.

关 键 词：肾功能衰竭 血液透析 心脏 胸部 X线 

分 类 号：R692.5[医药卫生—泌尿科学] R816.2[医药卫生—外科学]