<html> <head> <title>水肿</title> <meta http-equiv="Content-Type" content="text/html; charset=gb2312"> <link rel="stylesheet" href="../../../jk123.css"> <style type="text/css">  </style> </head> <body bgcolor="#FFFFFF"> <center> <table width="756" height="1" border="0" cellpadding="0" cellspacing="0"> <tr> <td width="241"> <div align="center"><img src="../../images/jk123logo.gif" width="202" height="52"></div> </td> <td width="503"> <div align="center"></div> </td> </tr> <tr> <td colspan="2" height="23" align="center"> <table width="100" border="0"> <tr> <td><a href="../../../default.asp"><img src="../../images/fpbutton-fp.gif" width="67" height="21" border="0"></a></td> <td><a href="../../default.asp"><img src="../../images/fpbutton-search.gif" width="90" height="21" border="0"></a></td> <td><a href="../../../treat/default.asp"><img src="../../images/fpbutton-treat.gif" width="67" height="21" border="0"></a></td> <td><a href="../../../health/default.asp"><img 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<table width="100%" border="0" cellspacing="0" cellpadding="0"> <tr> <td width="84%" class="f9"><a href="../../../default.asp">首页</a>><a href="../../default.asp">智能查询中心</a>><a href="../default.asp">症状</a>>常见症状</td> <td width="16%"> <div align="right"><a href="/sqgl/register/default.asp"><img src="../../images/corner-right-2.gif" width="89" height="20" border="0"></a></div> </td> </tr> </table> </td> </tr> <tr> </tr> </table> <table width="756" border="0" cellspacing="0" cellpadding="0"> <tr> <td colspan="2"> <hr size="1"> </td> </tr> </table> <table width="756" border="0" cellspacing="0" cellpadding="0"> <tr> <td width="147" valign="top" bgcolor="#EAFDEA"> <table width="147" border="0" cellspacing="0" cellpadding="0"> <tr> <td width="15" valign="top" bgcolor="#c4cd94"><img src="../../images/first/corner.gif" width="15" height="13"></td> <td width="117" bgcolor="#c4cd94"> <div align="center" class="f9"></div> </td> <td width="15" valign="top" bgcolor="#c4cd94"> </td> </tr> <tr valign="top"> <td colspan="3" class="f9"> <div align="center" class="f9"></div> <p align="left" class="f9"> </p> </td> </tr> <tr> <td colspan="3" class="f9" height="25">  输入疾病名称：</td> </tr> <tr> <td colspan="3"> <form action="../../../../zhcx/sick/JB_QueryList.asp" id=form1 method=post>    <input type="text" name=strSickName size=14> <input type="image" border="0" name="imageField" src="../../images/first/go.gif" width="20" height="22"> </form> </td> </tr> <tr bgcolor="#CCCC99"> <td colspan="3" height="18" class="f10">其他常见症状</td> </tr> <tr> <td colspan="3"> <ul> <li><a href="001.asp" target="_blank"><span class="f10">发热</span></a></li> <li><span class="f10"><a href="002.asp" target="_blank">乏力</a></span></li> <li><span class="f10"><a href="003.asp" target="_blank">头痛</a></span></li> <li><span class="f10"><a href="004.asp" target="_blank">咳嗽、咯痰</a></span></li> <li><span class="f10"><a href="005.asp" target="_blank">便血</a></span></li> <li><span class="f10"><a href="006.asp" target="_blank">腰痛</a></span></li> <li><span class="f10"><a href="007.asp" target="_blank">恶心、呕吐</a></span></li> <li><span class="f10"><a href="008.asp" target="_blank">腹痛</a></span></li> <li><span class="f10"><a href="010.asp" target="_blank">心悸</a></span></li> <li><span class="f10"><a href="011.asp" target="_blank">贫血</a></span></li> <li><span class="f10"><a href="012.asp" target="_blank">呼吸困难</a></span></li> </ul> </td> </tr> </table> </td> <td colspan="2" valign="top" width="609"> <table width="609" border="0" cellspacing="0" cellpadding="0"> <tr> <td width="18" rowspan="6"> </td> <td rowspan="3" valign="top" width="441" bordercolor="#CCCCCC"> <table width="100%" border="0" cellspacing="0" cellpadding="0"> <tr bgcolor="#D8E7DE"> <td class="f9" height="16"><b><font color="#0033CC" class="f10">水肿</font></b></td> </tr> </table> <p class="f9" align="center"><b><font color="#FF33FF">水肿的诊断程序</font></b></p> <table width="100%" border="1" cellspacing="0" cellpadding="0"> <tr bgcolor="#FFEEEE"> <td rowspan="24" class="f9" width="16%"> <div align="center">全身性水肿</div> <div align="center"></div> <div align="center"></div> <div align="center"></div> <div align="center"></div> <div align="center"></div> <div align="center"></div> <div align="center"></div> <div align="center"></div> <div align="center"></div> <div align="center"></div> <div align="center"></div> <div align="center"></div> <div align="center"></div> <div align="center"></div> <div align="center"></div> <div align="center"></div> <div align="center"></div> <div align="center"></div> <div align="center"></div> <div align="center"></div> <div align="center"></div> <div align="center"></div> <div align="center"></div> </td> <td rowspan="3" class="f9" width="19%"> <div align="center">心原性</div> <div align="center"></div> <div align="center"></div> </td> <td width="65%" class="f9"> <div align="left">右心衰竭(临床特征)</div> </td> </tr> <tr bgcolor="#FFEEEE"> <td width="65%" class="f9">缩窄性心包炎(X线、UCG超声心动图、心导管、CT检查)</td> </tr> <tr bgcolor="#FFEEEE"> <td width="65%" class="f9">心肌病(X线、UCG、ECG、心肌活检)</td> </tr> <tr bgcolor="#FFEEEE"> <td rowspan="3" class="f9" width="19%"> <div align="center">肾原性</div> <div align="center"></div> <div align="center"></div> </td> <td width="65%" class="f9">急性肾炎(尿常规、肾功能、肾活检检查)</td> </tr> <tr bgcolor="#FFEEEE"> <td width="65%" class="f9">慢性肾炎(尿常规、肾功能、肾活检检查)</td> </tr> <tr bgcolor="#FFEEEE"> <td width="65%" class="f9">肾病综合征(血中免疫球蛋白、尿C3含量、尿常规检查、蛋白电泳、尿溶菌酶等测定、肾活检检查)</td> </tr> <tr bgcolor="#FFEEEE"> <td rowspan="3" class="f9" width="19%"> <div align="center">肝原性</div> <div align="center"></div> <div align="center"></div> </td> <td width="65%" class="f9">肝硬化(肝功能、B超、肝活检检查)</td> </tr> <tr bgcolor="#FFEEEE"> <td width="65%" class="f9">肝癌(B超、肝活检、CT检查)</td> </tr> <tr bgcolor="#FFEEEE"> <td width="65%" class="f9">弥漫性肝坏死(肝功能、B超、肝活检检查)</td> </tr> <tr bgcolor="#FFEEEE"> <td rowspan="4" class="f9" width="19%"> <div align="center">营养不良性</div> <div align="center"></div> <div align="center"></div> <div align="center"></div> </td> <td width="65%" class="f9">低蛋白血症(血浆蛋白定量检查)</td> </tr> <tr bgcolor="#FFEEEE"> <td width="65%" class="f9">维生素B1缺乏(临床特征)</td> </tr> <tr bgcolor="#FFEEEE"> <td width="65%" class="f9">重度烧、冻伤(烧、冻伤史)</td> </tr> <tr bgcolor="#FFEEEE"> <td width="65%" class="f9">恶病质(重症消耗性疾病史)</td> </tr> <tr bgcolor="#FFEEEE"> <td rowspan="5" class="f9" width="19%"> <div align="center">内分泌性</div> <div align="center"></div> <div align="center"></div> <div align="center"></div> <div align="center"></div> </td> <td width="65%" class="f9">粘液性水肿(基础代谢，血浆蛋白结合碘、甲状腺131I吸收试验，T3、T4、TSH检查)</td> </tr> <tr bgcolor="#FFEEEE"> <td width="65%" class="f9">柯兴氏综合征(尿17-OHCS含量测定、地塞米松试验、；甲吡酮试验检查)</td> </tr> <tr bgcolor="#FFEEEE"> <td width="65%" class="f9">原发性醛固酮增多症(血浆醛固酮肾素测定，肾上腺扫描、造影检查)</td> </tr> <tr bgcolor="#FFEEEE"> <td width="65%" class="f9">垂体前叶功能减退(垂体及靶腺激素测定检查)</td> </tr> <tr bgcolor="#FFEEEE"> <td width="65%" class="f9">经前期紧张综合征(临床特征及内分泌激素测定)</td> </tr> <tr bgcolor="#FFEEEE"> <td rowspan="3" class="f9" width="19%"> <div align="center">结缔组织疾病</div> <div align="center"></div> <div align="center"></div> </td> <td width="65%" class="f9">皮肌炎(尿肌酸测定、EMG、肌肉活检检查)</td> </tr> <tr bgcolor="#FFEEEE"> <td width="65%" class="f9">硬皮病(蛋白电泳、皮肤活检检查)</td> </tr> <tr bgcolor="#FFEEEE"> <td width="65%" class="f9">播散性红斑狼疮(血查狼疮细胞、测定双链DNA抗体)</td> </tr> <tr bgcolor="#FFEEEE"> <td rowspan="3" class="f9" width="19%"> <div align="center">其他</div> <div align="center"></div> <div align="center"></div> </td> <td width="65%" class="f9">妊娠中毒症(肾素活力、硫酸铜脱氢表雄酮代谢廓清率及血压反应测定检查)</td> </tr> <tr bgcolor="#FFEEEE"> <td width="65%" class="f9">间脑综合征(病史、调查用药、症状)</td> </tr> <tr bgcolor="#FFEEEE"> <td width="65%" class="f9">特发性水肿(立、卧位水试验)</td> </tr> <tr bgcolor="#EEEEFF"> <td rowspan="8" class="f9" width="16%"> <div align="center">局限性水肿</div> <div align="center"></div> <div align="center"></div> <div align="center"></div> <div align="center"></div> <div align="center"></div> <div align="center"></div> <div align="center"></div> </td> <td rowspan="8" class="f9" width="19%"> <div align="center"></div> <div align="center"></div> <div align="center"></div> <div align="center"></div> <div align="center"></div> <div align="center"></div> <div align="center"></div> <div align="center"></div> </td> <td width="65%" class="f9">肢体血栓形成、血栓性静脉炎(电阻抗体积描记、上行性静脉造影)</td> </tr> <tr bgcolor="#EEEEFF"> <td width="65%" class="f9">下肢静脉曲张(病史)</td> </tr> <tr bgcolor="#EEEEFF"> <td width="65%" class="f9">慢性上腔静脉梗阻综合征(选择性上腔静脉造影)</td> </tr> <tr bgcolor="#EEEEFF"> <td width="65%" class="f9">慢性下腔静脉梗阻综合征(下腔静脉造影)</td> </tr> <tr bgcolor="#EEEEFF"> <td width="65%" class="f9">淋巴流受阻(皮肤活检、淋巴造影)</td> </tr> <tr bgcolor="#EEEEFF"> <td width="65%" class="f9">局部炎症(病史)</td> </tr> <tr bgcolor="#EEEEFF"> <td width="65%" class="f9">血管神经性(临床特征、排除性诊断)</td> </tr> <tr bgcolor="#EEEEFF"> <td width="65%" class="f9">过敏性(过敏史)</td> </tr> </table> <p class="f9" align="center"><b><font color="#FF33FF">水肿的鉴别诊断</font></b></p> <table width="100%" border="1" cellspacing="0" cellpadding="0"> <tr bgcolor="#FFEEEE"> <td class="f9" width="8%"> <div align="center"></div> </td> <td class="f9" width="9%"> <div align="center">水肿发生速度</div> </td> <td class="f9" width="14%"> <div align="center">水肿开始部位</div> </td> <td class="f9" width="16%"> <div align="center">水肿的性质</div> </td> <td class="f9" width="23%"> <div align="center">临床其他表现</div> </td> <td class="f9" width="30%"> <div align="center">确诊价值的检查</div> </td> </tr> <tr bgcolor="#EEEEFF"> <td class="f9" width="8%"> <div align="center">心性</div> </td> <td class="f9" width="9%"> <div align="center">逐渐形成</div> </td> <td class="f9" width="14%">下肢--全身</td> <td class="f9" width="16%">较坚实，移动性较小</td> <td class="f9" width="23%">心衰征象(心脏大、肝大、心杂音、颈静脉怒张)</td> <td class="f9" width="30%">ECG(心电图)、UCG(超声心动图)、心血管造影、冠状动脉造影、心肌活检</td> </tr> <tr bgcolor="#EEEEFF"> <td class="f9" width="8%"> <div align="center">肝性</div> </td> <td class="f9" width="9%"> <div align="center">缓慢</div> </td> <td class="f9" width="14%">下肢--腹部--全身</td> <td class="f9" width="16%">软，易移动</td> <td class="f9" width="23%">有肝炎史，慢性肝病的征象</td> <td class="f9" width="30%">肝功能、ICG(阻抗心动描记器)、γ-GT、α-FP、食管镜、腹腔镜、肝活检</td> </tr> <tr bgcolor="#EEEEFF"> <td class="f9" width="8%"> <div align="center">肾性</div> </td> <td class="f9" width="9%"> <div align="center">迅速</div> </td> <td class="f9" width="14%">眼睑--颜面--全身</td> <td class="f9" width="16%">软，易移动</td> <td class="f9" width="23%">肾病征象(高血压、蛋白尿、血尿、管型、眼底变化)</td> <td class="f9" width="30%">尿常规、尿系列蛋白、肾功能、X线、B超、肾活检</td> </tr> <tr bgcolor="#EEEEFF"> <td class="f9" width="8%"> <div align="center">内分泌性</div> </td> <td class="f9" width="9%"> <div align="center">较缓</div> </td> <td class="f9" width="14%">因病因不同而异</td> <td class="f9" width="16%">多为粘液水肿，少数心包、胸腹腔积液</td> <td class="f9" width="23%">相应内分泌病的症状表现</td> <td class="f9" width="30%">内分泌激素测寂静，TRH(促甲状腺释放激素)、LRH(促黄体释放激素)功能试验</td> </tr> <tr bgcolor="#EEEEFF"> <td class="f9" width="8%"> <div align="center">结缔组织病</div> </td> <td class="f9" width="9%"> <div align="center">较缓</div> </td> <td class="f9" width="14%">SLE(系统性红斑狼疮)轻肿，从面、踝部--全身，PSS特殊表现</td> <td class="f9" width="16%">血管病变，雷诺现象</td> <td class="f9" width="23%">多脏器损害，狼疮性肾病，PSS蜡样面容</td> <td class="f9" width="30%">自身抗体，IgC3,CH50，LE-B，皮肤活检</td> </tr> <tr bgcolor="#EEEEFF"> <td class="f9" width="8%"> <div align="center">营养不良</div> </td> <td class="f9" width="9%"> <p align="center">较缓</p> </td> <td class="f9" width="14%">与低蛋白血症有关</td> <td class="f9" width="16%">软，可移动</td> <td class="f9" width="23%">消瘦、乏力、恶液质状态、胩瘤、VitB1缺乏</td> <td class="f9" width="30%">Hb，A/G，有关营养不良病史，肿瘤及其他消耗性病检查</td> </tr> <tr bgcolor="#EEEEFF"> <td class="f9" width="8%"> <div align="center">特发性</div> </td> <td class="f9" width="9%"> <div align="center">有周期性规律</div> </td> <td class="f9" width="14%">水肿轻重不一，与体位有关</td> <td class="f9" width="16%">多见20-50岁女性，周期性水肿，腹胀</td> <td class="f9" width="23%">神经衰弱症状，肥胖，月经紊乱</td> <td class="f9" 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