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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(P>0.05)。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。
Objective: To investigate the application of CT peritoneoscopy in the diagnosis of local subcutaneous soft tissue edema in patients with continuous ambulatory peritoneal dialysis (CAPD). METHODS: Patients undergoing CAPD with local subcutaneous soft tissue edema between March 2015 and March 2016 were consecutively enrolled. 64-slice spiral CT scan, in the state of fasting abdominal abdominal CT scan. Then, 2 L of peritoneal dialysis solution mixed with 50 ml of non-ion contrast agent (iopamidol) was injected into the peritoneal cavity through the dialysis tube. About 30 min later, abdominal CT scan was performed. Comparative analysis of two CT images before and after contrast. Paired t test was used to analyze the difference of urine volume and ultrafiltration volume before and after angiography. Results: Totally 42 cases were enrolled in 425 cases. 35 cases had positive signs, including 18 cases of inguinal hernia, 2 cases of umbilical hernia, 1 case of incisional hernia, 2 cases of tunnel leakage, 5 cases of umbilical subcutaneous leakage, Retroperitoneal leakage in 6 cases, retroperitoneal leakage and subcutaneous leakage in 1 case. Surgical procedures have been confirmed. There was no significant difference in urine volume and ultrafiltration volume between before and after angiography (P> 0.05). Conclusion: CT peritoneography can accurately diagnose the etiology of local subcutaneous soft tissue edema in patients with CAPD, and can display the location of the lesion and the anatomic details, and provide a reliable basis for the selection of treatment methods, which has a high clinical value.