Basic Course of Diagnosis Edema 水肿 Xiaoqi XU Renal Divison, Renji Hospital, Shanghai second Med Univ
Basic Course of Diagnosis – Edema – -水肿 -Xiaoqi XU Renal Divison, Renji Hospital, Shanghai Second Med.Univ
Definition a clinical apparent increase in the interstitial fluid volume Distribution: local general Special form: ascites hydrothorax
Definition ◼ A clinical apparent increase in the interstitial fluid volume. ◼ Distribution: local general ◼ Special form: ascites hydrothorax
athogenesis Total body water(TBW): 2/3 body weight intracellular 2 3 BW interstitial 3/4 extracellular 1/3 starling orce intravascular 1/4 Starling force depends on: hydrostatic pressure(静水压) colloid oncotic pressure(胶体渗透压)
Pathogenesis Total body water(TBW): 2/3 body weight TBW intracellular 2/3 extracellular 1/3 Interstitial 3/4 intravascular 1/4 starling force Starling force depends on : hydrostatic pressure(静水压) colloid oncotic pressure（胶体渗透压）
Pathogenesis Disturbed starling forces(reduced effective circulating volume, edema formation systemic venous pressure Increase right-sided heart failure, constrictive pericarditis local venous pressure increase left-sided heart failure, vena cava obstruction, portal vein obstruction reduced oncotic pressure nephrotic syndrome, decreased albumin synthesis combined disorders cirrhosis
◼ Disturbed starling forces(reduced effective circulating volume,edema formation) systemic venous pressure increase right-sided heart failure,constrictive pericarditis local venous pressure increase left-sided heart failure,vena cava obstruction, portal vein obstruction reduced oncotic pressure nephrotic syndrome,decreased albumin synthesis combined disorders cirrhosis Pathogenesis
Primary hormone excess (increased effective circulating volume) primary aldosteronism Cushing 's syndrome SIADH Primary renal sodium retention (increased effective circulating volume) renal failure SIADH: syndrome of inappropriate antidiuretic hormone production
◼ Primary hormone excess (increased effective circulating volume) primary aldosteronism Cushing ‘s syndrome SIADH ◼ Primary renal sodium retention (increased effective circulating volume) renal failure SIADH: syndrome of inappropriate antidiuretic hormone production