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
发布时间：2018-09-04 12:56
【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。然后将混合有50 ml非离子对比剂(碘帕醇)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,包括腹股沟疝18例、脐疝2例、切口疝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1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。
[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.
【作者单位】： 西南医科大学附属医院放射科;四川大学华西医院放射科;四川大学华西医院肾内科;
【分类号】：R459.5;R816.7
本文编号：2222168
[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.
【作者单位】： 西南医科大学附属医院放射科;四川大学华西医院放射科;四川大学华西医院肾内科;
【分类号】：R459.5;R816.7
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