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肺水肿是一严重临床问题,尤其在肾衰患者。Alwall发现有肺水肿的尿毒症患者的死亡率,比单纯尿毒症患者要高一倍。在这类患者,采取利尿这一主要的治疗方法来清除水分可能不行,而需要透析治疗。一般认为肾衰患者的肺水种是由多种因素引起的,包括肺毛细血管内液体静压增高,血浆胶体渗透压降低,以及尿毒症毒素对支气管毛细管和血管滋养管造成的损伤。尿毒症性肺水肿的诊断靠临床检查,血液动力学压力测定,血液化学,以及最为重要的胸部X线检查作出。典型的X线胸片表现为局限于肺中心的间质浸润,肺周围一般清晰,这就是通常所说的蝴蝶状或蝙蝠翅状浸润。
Pulmonary edema is a serious clinical problem, especially in patients with renal failure. Alwall found that patients with uremia who had pulmonary edema had twice as much mortality as those with uremia alone. In such patients, the main treatment of diuretic to remove water may not work, but the need for dialysis treatment. Lung water is generally considered due to a variety of factors caused by renal failure, including pulmonary capillary hydrostatic pressure, decreased plasma colloid osmotic pressure, and uremic toxins on bronchial capillaries and vascular nodules caused damage. Diagnosis of uremic pulmonary edema is based on clinical tests, hemodynamic stress tests, blood chemistry, and, above all, chest radiography. Typical chest radiographs appear to be confined to interstitial infiltrates of the lungs, usually clear around the lungs, which is commonly referred to as butterfly-shaped or bat-wing infiltration.