血液透析过程并发出血性心包炎是尿毒症患者的重要死因,因此对此早期诊断、正确处理具有重要意义。现将我院遇到的两例报告如下。 例1 男,26岁。主因纳差、恶心、下肢肿1年余,加重伴呕吐20天于1989年11月17日入院。6岁时曾患“急性肾小球肾炎”。体检:血压24/19kPa,贫血貌。心界向左扩大,心率94次/分,律齐,心尖部有Ⅱ级收缩期杂音及广泛的心包摩擦音。双肺下呼吸音低。腹部有移动性浊音,肝肋下2cm,质中,脾未及。双下肢明显水肿。实验室检查:血红蛋白43g/L,血小板120×10~9/L,出血时间1分,凝血时间5分,血BUN 52.1mmol/L,Cr 1833.4μmol/L,Ccr 2ml/min。尿渗透压371mmol/L,尿蛋白(++)比重1.010。住院后立即行血液透析(每周3次,每次4小时,用醋酸盐透析液常规透析)及对症治疗,症状明显好转。血液透析10次后,患者在11天内先后5次 Hemodialysis process and hemorrhagic pericarditis is an important cause of uremia patients, so the early diagnosis and proper treatment is of great significance. Now I met two hospital reports are as follows. Example 1 male, 26 years old. The main cause of anorexia, nausea, lower extremity swelling more than 1 year, increased with vomiting 20 days in November 17, 1989 admission. 6 years old had “acute glomerulonephritis.” Physical examination: blood pressure 24 / 19kPa, anemia appearance. Heart to the left to expand, heart rate 94 beats / min, law Qi, apical systolic murmur and a wide range of pericardial frictional sound. Lower lung breath sounds low. Abdominal motility dull, liver ribs 2cm, quality, spleen and time. Double lower extremity obvious edema. Laboratory tests: hemoglobin 43g / L, platelet 120 × 10 ~ 9 / L, bleeding time 1 minute, clotting time 5 minutes, blood BUN 52.1mmol / L, Cr 1833.4μmol / L, Ccr 2ml / min. Urine osmolality 371mmol / L, urinary protein (++) specific gravity 1.010. Hemodialysis immediately after hospitalization (3 times a week, every 4 hours, dialysis with acetate dialysis) and symptomatic treatment, the symptoms were significantly improved. Hemodialysis 10 times, the patient has 5 times in 11 days