CT腹膜腔造影在诊断持续非卧床腹膜透析患者局部皮下软组织水肿中的应用.pdfVIP

肾脏病与透析肾移植杂志第 25 卷第 4 期 2016 年 O唱月 .335 . CT 腹膜腔造影在诊断持续非卧床腹膜透析患者 局部皮下软组织水肿中的应用 白娇l 刘荣波2 钟慧3 摘 要 目的:探讨 CT腹膜腔造影在诊断持续非卧床腹膜透析(CAPD)患者合并局部皮下软组织水肿中的 应用。 方法:连续收集 2015 年 3 月至 2016 年 3 月间接受 CAPD 治疗且合并局部皮下软组织水肿患者。采用 64 层螺旋 CT 扫描，在空腹腔状态下先行腹腔 CT 常规平扫。然后将握合有 50 ml 非离子对比剂(腆帕醇)的 2L 腹膜 透析液经透析管注入腹腔，约 30 min 后，再行腹腔 CT 扫描。比较分析造影前后两次 CT 检查图像。采用配对 t 检 验分析造影前后 24h 尿量与超滤量的差异。 结果:随访 425 例患者中共 42 例纳入研究，其中 35 例有阳性征象， 包括腹股沟痛 18 例、脐痛 2 例、切口由 1 例、隧道内渗漏 2 例、脐部皮下渗漏 5 例、腹膜后渗漏 6 例、腹膜后渗漏并 皮下渗漏 l 例。有手术条件者经手术均得到证实。造影前后 24h 尿量与超滤量差异无统计学意义(P0.05) 。 结论 :CT 腹膜腔造影能准确地诊断 CAPD 患者合并局部皮下软组织水肿病因，并能显示病变发生位置及解剖细 节，为治疗手段的选择提供可靠依据，具有较高临床应用价值。 关键词 体层摄影术 X 线计算机持续非卧床腹膜透析腹膜腔造影 Value of CT peritoneography in diagnosis of localized subcutaneous edema during continuous ambulatory peritoneal dialysis BAl liao 1 ,UU Rongb0 2 ,ZHONG Hui 3 1 Department of Radiology , the Ajj日:tiated Hosptital of Southwest Medical University , Luzhou Sichuan , 646α)() 2 Department of Radiology , West China Ho甲ital , Sichoon University , Chengdu Sichuan , 610041 3 Department of Nephrology , West China Hospital , Sichoon University , Chengdu Sichωn ， 610041 Corresponding author:ZHONG Hui(E-mail:zhonghui39@126.com) ABSTRACT Objective: To assess the diagnostic value of the CT peritoneography for localized subcutaneous edema during continuous arnbulatory peritoneal dialysis (CAPD). Methodology: We perlormed a prospective analysis of continuous collecting subjects in our nephrology department who occurred localized subcutaneous edema when accepted CAPD during March 20l5-March 20l6.Using Philips Brilliance Plus 64 CT scan. The conventionally CT was obtained. Then 50 mL non-ionic contrast medium (lopamidol) was mixed with 2L dialysate and infused into the peritoneal cavity via Tenchkoff catheter. Peritoneography phase scanning was obtained 30 mins later. Then diagnosis was made. The urine volume and ultrafiltration volume in 24h before and after CT Peritoneography were compared using paired t test. Results: 42 out of 425 follow-up case