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尿毒症时所见的肺病变,最初由放射科医师报道,称之为“尿毒肺”。但其后证实尿毒肺的本质是肺水肿。由于这种状态往往合并进行性肾功能衰竭,因此目前仍使用“尿毒肺”的术语描述这一临床病症。 我科收治了近200例尿毒症病人,多在基层医院,尤其是无条件进行透析的医院,医师对尿毒症肺病的病理认识不够,误诊误治率较高。现列举如下: 1 误诊为急性左心功能不全。 因为尿毒症性肺水肿病人症状上与急性左心功能不全相似,患者多胸闷气短、心慌,夜间阵发性呼吸困难,不能平卧入睡,严重时咳嗽,咯血性泡沫痰,多伴有水肿。查体:双肺布满干湿性罗音,误诊为急性左心功能不全。给予扩血管利尿、强心治疗多日无效,且增加体内液体潴留,反而使症状加重。就
Lung lesions seen during uremia, initially reported by radiologists, are called “uremic lungs.” But later confirmed the essence of uremic lung is pulmonary edema. As this condition is often associated with progressive renal failure, the term “uremic lung” is still used to describe this clinical condition. Our department admitted nearly 200 cases of uremic patients, mostly in grass-roots hospitals, especially in dialysis hospitals unconditionally, physicians do not understand the pathology of uremic pulmonary disease, misdiagnosis and misdiagnosis rate. Are listed below: 1 misdiagnosed as acute left heart failure. Because of symptoms of uremic patients with pulmonary edema and acute left ventricular dysfunction is similar to patients with chest tightness and shortness of breath, palpitation, paroxysmal nocturnal dyspnea, can not lie down to sleep, severe cough, hemoptysis foam sputum, accompanied by edema. Physical examination: lungs covered with wet and dry rales, misdiagnosed as acute left heart failure. Give vasodilatation vasodilator, cardiac treatment for many days invalid, and increase fluid retention in the body, but to make the symptoms worse. on