Uremic Pericarditis and Long-Term Chronic Hemodialysis Treatment

Year 1976, Volume: 29 Issue: 4 , 907 - 926 , 31.12.1976

A.ergün Ertuğ

https://izlik.org/JA73EE48ZZ

Abstract

Üremik Perikarditler ve Uzun Süreli Hemodializ Tedavisi
İç Hastalıkları Kliniğinde Temmuz - 1975 ve Ocak - 1977 tarihleri arasında 27 kronik böbrek yetmezlikli vakaya kronik
hemodializ tedavisi uygulanmıştır. Bunlardan 6 tanesi perikarditli olup, perikardit vakalarından ikisi dializ tedavisine başlandıktan sonra (5 ay ve 14 ay) oluşmuştur. Üç vakada tamponet
ortaya çıkmıştır. Bu vakalarda bölgesel heparinizasyonlu hemodializ, perikardiosentez, ve İndomethacin tedavisi uygulanmıştır. Üç vakada perikardit tamamen gerilemiş, bir vakada
kronik konstriktif perikardit oluşmuş, diğer iki vaka ise kısa bir süre içinde ölmüşlerdir.
Etyopatogenezleri bugün için açık olmayan üremik perikarditler bazı non - spesifik yöntemler ile tedavi edilebilmektedirler. Bu tedavi, aşağıda ki şekilde sıralanabilir :
1 — Bölgesel heparinizasyon ile sık ve yoğun hemodializ,
2 — Durumda düzelme olmamış ve akut kalb tamponadı
bulguları yok ise İndomethacin, tamponat var ise perikardiosentezden sonra İndomethacin verilir.
3 — Yine düzelme olmazsa, perikard içine, emilime uğramayan steroidlerin verilmesi gerekir,
4 — Bunlar yeterli olmuşorsa cerrahi tedavi ve tercihan.
parsiel perikardiektomiye gidilmelidir.

Keywords

perikardit , hemodiyaliz , tedavi

Üremik Perikarditler ve Uzun Süreli Kronik Hemodializ Tedavisi

https://izlik.org/JA73EE48ZZ

Abstract

Uremic Pericarditis and Long-Term Hemodialysis Treatment
Chronic hemodialysis treatment was applied to 27 chronic renal failure cases in the Internal Medicine Clinic between July - 1975 and January - 1977. Six of them had pericarditis, and two of the pericarditis cases occurred after the dialysis treatment was started (5 months and 14 months). Tamponade occurred in three cases. Regional heparinized hemodialysis, pericardiocentesis, and Indomethacin treatment were applied in these cases. Pericarditis completely regressed in three cases, chronic constrictive pericarditis occurred in one case, and the other two cases died in a short time.
Uremic pericarditis, the etiopathogenesis of which is not clear today, can be treated with some non-specific methods.
This treatment can be listed as follows:

1 — Frequent and intensive hemodialysis with regional heparinization,
2 — If there is no improvement in the condition and there are no signs of acute cardiac tamponade, Indomethacin is given, if there is tamponade, Indomethacin is given after pericardiocentesis.
3 — If there is still no improvement, non-absorbable steroids should be given into the pericardium,
4 — If these are sufficient, surgical treatment and preferably partial pericardiectomy should be performed.

Keywords

perikardit , tedavi , hemodiyaliz

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