慢性肾衰竭血液透析患者尿毒症性口炎

Alamsyah Piliang, Nelly Nainggolan, Riani Setiadhi
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摘要

有或没有血液透析的终末期肾脏疾病患者都有经历许多合并症的风险,包括高血压、贫血、出血风险,并有与疾病本身或血液透析相关的口腔表现;例如尿毒症性口炎。本文描述了终末期肾脏疾病患者接受血液透析的尿毒症性口炎。一名患有慢性肾脏疾病的14岁女孩已经接受了血液透析,她身体虚弱,面色苍白,之前曾呕吐,口疮,难以进食。口外表现为结膜贫血,唇干,脱屑,糜烂伴血红色结痂,易出血,多发紫癜及下唇点。口腔内显示舌腹白色菌斑无法清除。下唇粘膜糜烂区及白色假膜疼痛,多处白色斑块可剥落,右侧颊黏膜红斑区,左侧颊黏膜紫癜。实验室检查支持诊断为尿毒症性口炎和剥脱性唇炎。为克服症状,改善口腔状况,患者给予0.12%双露酸氯己定0.12%、0.9% NaCl溶液、氨甲环酸瓶与水混合液、凡士林影集治疗。结论尿毒症性口炎是终末期肾脏疾病的一种口腔表现,适当的治疗可提高患者的生活质量。
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Uremic stomatitis in patients with chronic renal failure undergoing hemodialysis
Patients with end-stage renal disease with or without hemodialysis are at risk of experiencing a number of comorbidities inclu-ding hypertension, anemia, risk ofbleeding and have oral manifestations related to the disease itself or due to hemodialysis; for example uremic stomatitis. This article describes uremic stomatitis in end-stage renal disease patient undergoing hemodialysis. A 14-year-old girl with chronic kidney disease had already undergoing hemodialysis, came with weak, pale condition and pre-viously vomiting, complaining sore mouth and difficult to eat. Extra oral revealed anemic conjunctiva, dry lips, exfoliative, ero-sive with serosanguinolenta crusts, tend to bleed, multiple purpuras and petechiae on the lower lip. Intra oral showed white plaque cannot be scrapped off on theventral tongue. Painful erosive area and white pseudomembranes on the lower labial mu-cosa, multiple white plaques can be scrapped off leaving erythematous area on the right buccal mucosa, purpura on the left buc-cal mucosa. Laboratory examination supported the diagnosis as as uremic stomatitis and exfoliative cheilitis. To overcome the complaints and improve the oral condition, the patient was treated with 0.12% chlorhexidine digluconate 0.12%, 0.9% NaCl solution, a mixture of tranexamic acid vials and aqua bides, and vaseline album. It was concluded that uremic stomatitis is an oral manifestation of end-stage renal disease, and appropriate therapy will improve the quality of life of the patient.
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