【摘要】：目的:探討CT腹膜腔造影在診斷持續(xù)非臥床腹膜透析(CAPD)患者合并局部皮下軟組織水腫中的應(yīng)用。方法:連續(xù)收集2015年3月至2016年3月間接受CAPD治療且合并局部皮下軟組織水腫患者。采用64層螺旋CT掃描,在空腹腔狀態(tài)下先行腹腔CT常規(guī)平掃。然后將混合有50 ml非離子對(duì)比劑(碘帕醇)的2L腹膜透析液經(jīng)透析管注入腹腔,約30 min后,再行腹腔CT掃描。比較分析造影前后兩次CT檢查圖像。采用配對(duì)t檢驗(yàn)分析造影前后24h尿量與超濾量的差異。結(jié)果:隨訪425例患者中共42例納入研究,其中35例有陽(yáng)性征象,包括腹股溝疝18例、臍疝2例、切口疝1例、隧道內(nèi)滲漏2例、臍部皮下滲漏5例、腹膜后滲漏6例、腹膜后滲漏并皮下滲漏1例。有手術(shù)條件者經(jīng)手術(shù)均得到證實(shí)。造影前后24h尿量與超濾量差異無(wú)統(tǒng)計(jì)學(xué)意義(P0.05)。結(jié)論:CT腹膜腔造影能準(zhǔn)確地診斷CAPD患者合并局部皮下軟組織水腫病因,并能顯示病變發(fā)生位置及解剖細(xì)節(jié),為治療手段的選擇提供可靠依據(jù),具有較高臨床應(yīng)用價(jià)值。
[Abstract]:Objective: to investigate the application of CT peritoneal cavity angiography in the diagnosis of subcutaneous soft tissue edema in (CAPD) patients with continuous ambulatory peritoneal dialysis. Methods: patients with subcutaneous soft tissue edema were collected from March 2015 to March 2016. 64-slice spiral CT scan was used, and the normal plain scan of CT was performed under the condition of empty abdominal cavity. Then 2L peritoneal dialysate mixed with 50 ml non-ionic contrast agent (iodiol) was injected into peritoneal cavity through dialysis tube. After 30 min, the peritoneal CT scan was performed again. Two CT images before and after angiography were compared and analyzed. The difference of 24 h urine volume and ultrafiltration before and after angiography was analyzed by paired t test. Results: a total of 42 patients were followed up, of whom 35 had positive signs, including inguinal hernia in 18, umbilical hernia in 2, incisional hernia in 1, intratunnel leakage in 2, subcutaneous leakage in umbilical cord in 5 and retroperitoneal leakage in 6. Retroperitoneal leakage and subcutaneous leakage occurred in 1 case. Surgical conditions were confirmed by surgery. There was no significant difference between 24 h urine volume and ultrafiltration before and after angiography (P0.05). Conclusion Peritoneal CT angiography can accurately diagnose the etiology of local subcutaneous soft tissue edema in patients with CAPD, and can show the location and anatomical details of the lesion. It can provide reliable basis for the choice of treatment methods and has high clinical application value.
【作者單位】： 西南醫(yī)科大學(xué)附屬醫(yī)院放射科;四川大學(xué)華西醫(yī)院放射科;四川大學(xué)華西醫(yī)院腎內(nèi)科;
【分類號(hào)】：R459.5;R816.7

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