腹腔CT影像学检查在腹膜透析相关非感染性腹腔并发症中的诊断价值

目的：初步探讨腹腔CT影像学检查在诊断持续性非卧床腹膜透析（continuous ambulatory peritoneal dialysis，CAPD）患者非感染性腹腔并发症中的应用价值。方法：前瞻性地对2005年至2007年间在我院进行CAPD治疗且临床高度怀疑为透析相关非感染性腹腔并发症的患者进行腹腔CT影像学检查。结合临床资料，综合分析患者是否存在腹腔渗漏、疝气、局部腹透液的聚集和大网膜包裹等情况，评估腹腔CT影像学检查的应用价值。结果：腹腔CT造影检查发现，11例CAPD患者中有9例出现异常情况，其中包括腹股沟疝气3例，睾丸鞘膜积液1倒，脐疝1例，导管出口处渗漏2例，大网膜包裹2例；其中8例（腹股沟疝气2例，睾丸鞘膜积液1例，脐疝1例，导管出口处渗漏2例，大网膜包裹2例）有手术条件的患者经过手术均得到证实。结论：在一些存在可疑腹膜透析相关非感染性腹腔并发症的CAPD患者中，腹腔CT影像学检查可能是一种无刨、可靠且灵敏度较高的检查技术，操作简便易行，有助于明确诊断，值得进一步研究。

Diagnostic value of CT peritoneography for non-infectious complications of peritoneal dialysis

OBJECTIVE: To assess the diagnostic value of CT peritoneography for peritoneal complications of continuous ambulatory peritoneal dialysis (CAPD). METHODS: CT peritoneography in 11 CAPD patients with clinically suspected dialysis-related complications was prospectively studied. The CAPD patients were all treated in Renji Hospital from 2005 to 2007. CT images were reviewed according to the evidence of peritoneal leaks, hernias, loculate pleural fluid collections, and adhesions. RESULTS: Abnormal findings were found in 9 of 11 CAPD cases including inguinal hernias (3 cases), umbilical hernia (1 case), hydrocele (1 case), leaks in catheter tunnel (2 cases), and peritoneal adhesions (2 cases). Parts of them were confirmed by surgical operation. CONCLUSION: CT peritoneography is useful for the evaluation of complications related to CAPD, and it offers excellent tissue contrast and multiplanar imaging for assessment of the complications.