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透析失衡综合征

Author
Lionel U Mailloux, MD, FACP
Section Editor
Jeffrey S Berns, MD
Deputy Editor
Alice M Sheridan, MD
Translators
周莉, 副主任医师

引言

透析失衡综合征(dialysis disequilibrium syndrome, DDS)是一种越来越罕见的综合征，其特征是发生于透析患者的严重程度不同的神经系统症状，尤其是当患者首次开始血液透析时[1,2]。目前认为主要是脑水肿所致。

本专题将总结DDS。关于透析期间精神状态改变和其他急性问题参见其他专题。 (参见“血液透析期间的急性并发症”和“Psychiatric illness in dialysis patients”和“血液透析患者的癫痫发作”)

流行病学和危险因素

DDS的发病率很不明确，且不同患者群中各不相同。大多数报告称发病率已经下降[2-4]。由于常规采用了下文中的推荐预防措施，目前成人中的严重DDS罕见(参见下文‘预防’)。发病率下降还有一个可能的原因，即现在的患者开始透析治疗时的血尿素浓度比以往的患者低得多[3]。然而，一些报道指出，由于临床表现多样，该综合征有少报的情况[5]。不太严重的症状(如，肌肉痛性痉挛和头晕)可能是DDS的表现，但常常未被报道。

DDS的危险因素包括以下方面[2-6]：

●首次透析治疗

        

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Literature review current through: 2017-06 . | This topic last updated: 2016-08-01.
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