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腹壁及外生殖器肿胀是持续可动性腹膜透析(CAPD)过程中可能出现的棘手并发症。由于常规放射照片及同位素扫描方法难以显示肿胀的确切性质及明确的解剖学边界,故临床处理有一定困难。作者采用水溶性非离子对比剂注入腹膜腔后CT扫描检查,对十例CAPD患者下腹壁或阴囊肿胀进行评价,效果满意。男性5例,女性2例,均为肾功能衰竭病人。在出现腹壁或阴囊肿胀前放置Tenckhoff导管行CAPD时间为8～28个月,出现腹壁或阴囊肿胀时间为1日至数周。CT扫描不需特殊准备,加入100ml水溶性非离子对比剂(每ml含碘300～370mg)于2升透析液中,经腹膜腔引流管对比剂进入腹腔。鼓励病人多活动,1～2小时后行CT扫描。如扫描结果阴性或可疑,可在加入对比剂4小时或24小时后再次扫描。扫描位置从Tenckhoff导管插入上方3cm至耻骨联合处,男性患者加行阴囊扫描。
The swelling of the abdomen and genitals is a thorny complication that may occur during a continuous peritoneal dialysis (CAPD). Because conventional radiography and isotope scanning methods are difficult to show the exact nature of swelling and a clear anatomical boundary, so the clinical treatment has some difficulties. The authors used water-soluble non-ionic contrast agent into the peritoneal cavity after CT scan examination, the ten cases of CAPD patients with lower abdominal wall or scrotal swelling were evaluated with satisfactory results. 5 males and 2 females, all of whom were patients with renal failure. Tendhoff catheters were placed in front of the abdominal wall or scrotum swelling CAPD time is 8 to 28 months, abdominal wall or scrotal swelling occurred from 1 to several weeks. CT scan without special preparation, adding 100ml water-soluble non-ionic contrast agent (each containing iodine 300 ~ 370mg) in 2 liters of dialysate, peritoneal drainage tube contrast agent into the abdominal cavity. Encourage patients to more activities, 1 to 2 hours after the line CT scan. If the scan is negative or suspicious, scan it again 4 or 24 hours after adding contrast media. The scan location was 3 cm above the Tenckhoff catheter into the pubic symphysis, and the male patient underwent a scrotal scan.