体液常规 检查 英文.pptVIP

Pathogenic Mechanisms in Ascites Formation B) 胶体渗透压减低Decreased colloid osmotic pressure1.End-stage liver disease with poor protein synthesis2.Nephrotic syndrome with protein loss3.Malnutrition4.Protein-losing enteropathy Pathogenic Mechanisms in Ascites Formation C) 毛细血管通透性增加Increased permeability of peritoneal capillaries1.Tuberculous peritonitis2.Bacterial peritonitis3.Malignant disease of the peritoneum Pathogenic Mechanisms in Ascites Formation D) Leakage of fluid into the peritoneal cavity1.Bile ascites2.Pancreatic ascites(secondary to a leaking pseudocyst)3.Chylous ascites4.Urine ascites Pathogenic Mechanisms in Ascites Formation E)其它原因 Miscellaneous causes1.Myxedema粘液性水肿2.Ovarian disease(Meigs‘ syndrome) 卵巢纤维瘤伴胸腹水（或其它盆腔肿瘤伴胸腹水）3.Chronic hemodialysis 血液透析 Separating transudates and exudates An exudate meets one or more of the following criteria while a transudate meets none: Pleural fluid/serum protein 0.5 Pleural fluid/serum LDH 0.6 Pleural fluid LDH two-thirds of upper normal limit for serum Newer tests for differentiating transudates and exudates Proposed tests have included the levels of cholesterol, bilirubin, and cholinesterase in the pleural fluid and the difference (gradient) between the albumin in the pleural fluid and serum In general Light’s criteria occasionally misidentify a transudative effusion as an exudative effusion Clinically if a patient should have a transudative effusion, but meets Light’s criteria for an exudative effusion, measure serum - pleural fluid albumin gradient Gradient of 1.2 g/dl indicates transudate Gross examination of pleural fluid Appearance Chardonnay - yellow - if cloudy - centrifugate cloudy supernatant - chylothorax or pseudochylothorax clear supernatant - cells or debris responsible for cloudiness Rose - blood -tinged Cabernet Sauvignon - obtain HCT hemothorax if HCT 20% Odor Putrid -anaerobic empyema Urine - urinothorax Initial laboratory tests for an undiagnosed pleural effusion Protein