中国血液净化

中国血液净化 ›› 2017, Vol. 16 ›› Issue (02): 117-120.doi: 10.3969/j.issn.1671-4091.2017.02.012

• 临床研究 • 上一篇    下一篇

CT腹膜腔造影在诊断持续非卧床腹膜透析合并胸腔积液中的价值

白娇1,刘荣波2,钟慧3   

  1. 1. 西南医科大学附属医院放射科
    2. 四川大学华西医院放射科
    3. 四川大学华西医院肾内科
  • 收稿日期:2016-07-25 修回日期:2016-11-17 出版日期:2017-02-12 发布日期:2017-02-12
  • 通讯作者: 钟慧 zhonghui39@126.com E-mail:zhonghui39@126.com

Value of CT peritoneography in the diagnosis of continuous ambulatory peritoneal dialysis-related hydrothorax

  • Received:2016-07-25 Revised:2016-11-17 Online:2017-02-12 Published:2017-02-12

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摘要： 目的探讨CT 腹膜腔造影在诊断持续非卧床腹膜透析合并胸腔积液中的临床应用价值。方法连续收集四川大学华西医院肾内科2015 年12 月～2016 年5 月期间接受持续非卧床腹膜透析治疗且合并胸腔积液患者。采用64 层螺旋CT 扫描，先行胸部及上腹部CT 常规平扫。再将混合有50ml 非离子对比剂(碘帕醇)的2L 腹膜透析液经腹透管注入腹腔，约30min 后，再行胸部及上腹部CT 扫描。比较分析造影前后2 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225例患者中共18 例成功纳入研究，其中3 例有阳性征象，其中胸-腹腔漏2 例，纵隔-腹腔漏1 例。造影前后24h 尿量与超滤量差异无统计学意义(t=0.674, P=0.509；t=1.212,P=0.242)。结论CT 腹膜腔造影能准确地诊断持续非卧床腹膜透析合并胸腔积液病因，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, 腹膜腔造影, 持续非卧床腹膜透析, 胸腔积液

Abstract: Objective To assess the diagnostic value of CT peritoneography for continuous ambulatory peritoneal dialysis-related hydrothorax. Methods We sequentially recruited patients who were treated with continuous ambulatory peritoneal dialysis (CAPD) and had the complication of hydrothorax during Dec. 2015 to May 2016 in our hospital. Using Philips Brilliance Plus 64 CT scanner, conventional CT scans on thorax and upper abdomen were first performed, and then 50 mL non-ionic contrast medium (Iopamidol) mixed with 2L dialysate were infused into peritoneal cavity via Tenchkoff catheter. CT scans on thorax and upper abdomen were repeated after the infusion for 30 minutes. Images were compared before and after the infusion. The differences in 24h urine volume and ultrafiltration volume before and after CT Peritoneography were compared using paired t test. Results Eighteen out of the 225 follow- up cases were successfully enrolled into this study. Abnormal findings were found in 3 cases, including pleuraperitonum communication (2 cases) and peritonum-mediastinum leakage (one case). There was no statistically differences in 24h urine volume and ultrafiltration volume before and after CT Peritoneography (t= 0.674, P=0.509 for 24h urine volume; t=1.212, P=0.242 for ultrafiltration volume). Conclusion CT peritoneography can provide us with accurate diagnosis of CAPD-related hydrothorax, and reveal anatomical abnormalities regarding location and size, valuable for the pathogenesis and treatment of hydrothorax in CAPD patients.

Key words: X-ray computed tomography, peritoneography, continuous ambulatory peritoneal dialysis, hydrothorax