背景:連續可活動性腹膜透析是末期腎病常用的治療方式,其併發症包括透析液渗漏,如水胸、腹部和外陰部水腫,本篇報告闡述腹膜閃爍攝影於透析液渗漏的診斷價値。方法:從1991年6月到1999年10月,10個接受連續可活動性腹膜透析而懷疑透析液渗漏的患者接受閃爍攝影檢查。腹膜閃爍攝影的步骤是經由腹膜透析管(Tenckhoff catheter)灌入含有111MBq(3 mCi)鎝-99m-MAA的透析液到腹膜腔内,以加馬攝影機收集動態影像及六小時以内的靜態影像。結果:在这10位患者的閃爍攝影檢查中,腹膜閃爍攝影偵測到5個腹胸膜交通、3個肚臍周圍渗漏、1個渗漏到右側陰囊、1個病人渗漏到右側大陰唇。一位肚臍周圍渗漏患者經治療後,追蹤腹膜閃爍攝影顯示仍持續有渗漏現象。另一位大陰唇渗漏患者,第二次檢查顯示有腹部缺損渗漏,第三次追蹤影像則恢復正常。結論:我們的結果顯示腹膜閃爍攝影對於使用連續可活動性腹膜透析而導致透析液渗漏的病人來說,是一種高敏感度、沒有侵襲性、相當万便、並且具有診斷價値的檢查方法。
Background: Continuous ambulatory peritoneal dialysis (CAPD) has several advantages. However, some complications including dialysate leakage may occur. In this study, we investigated the value of peritoneal scintigraphy in evaluating dialysate leakage in patients undergoing CAPD. Methods: Ten patients underwent CAPD between June l99l and October l999 and suspected to have dialysate leakage were included in this study. Peritoneal scintigraphy was performed after administration of 111 MBq (3 mCi) of 99mTc-MAA in dialysis solution into the peritoneal cavity via the Tenckhoff catheter. Initial dynamic imaging and subsequent images over a 6-h period were obtained. Results: Dialysate leakage was demonstrated by peritoneal scintigraphy in all 10 patients, including 5 peritoneopleural communication, 3 periumbilical leakage (two episodes in patient 6), 1 leakage into the right hemiscrotum, and 1 (patient 9) leakage into the right labia major at the first time and leakage via abdominal wall defect at the second time. A follow-up scan of patient 9 had negative result. Conclusion: Peritoneal scintigraphy is a highly sensitive, non-invasive, and convenient procedure with diagnostic value in evaluating dialysate leakage encountered in patients on CAPD.