静脉肾盂造影相关问题分析

Analysis on the correlative problems of intravenous pyelography

目的对造影前肠腔准备和造影拍片时机进行探讨与总结,以期达到最佳的造影检查结果。方法46例病人行静脉肾盂造影检查,造影前一日禁食易产气食物,造影前一日晚口服泻药,于检查前将粪便排泄干净。肠道准备情况分为优、良、一般、差。检查时,检查床向头侧倾斜20°～30°,经肘静脉注射非离子造影剂60mL,90s以内注射完毕。随后3min～5min拍摄第1张,10min～15min拍摄第2张,如诊断需要时,可延迟30min或更长时间再拍片。结果46例中的23例造影前肠道准备情况为一般,14例为良好,4例为优,可以做造影检查的41例,占89.1%;有5例造影前准备较差,不可以做检查,占10.9%。透视下观察,41例于造影后30s～40s时,肾脏轮廓可以显示,正常肾脏皮质与髓质分界明确;40例5min时,一侧或两侧肾盂肾盏开始充分显影,45例15min时充分显影并可追踪到输尿管影像。结论细致的肠道清洁工作是做好静脉肾盂造影的基础。除做好常规准备外,还应做到造影前3d禁食易产气食物,造影前少讲话因吞咽和讲话都会使气体进入肠道,同时还要禁止清洁灌肠。注射造影剂后30s～40s拍摄肾实质片;造影即将结束时,要在一张X线片上拍摄泌尿系统影像。

Objective To search for the enteric cavity preparation before intravenous pyelography （IVP） and the best photo time to expect aehiveing the best result IVP. Methods Forty-six patients who underwent IVP were analyzed retrospectively. At the day before IVP, the aerogenie foods should be forbidden while at the height before IVP, the cathartic drug could be administrated and the contents in enteric cavity should be all excreted. The conditions of the enteric cavity preparation could be divided into excellent, good, common, and poor. Examine table incline about 20° to 30° headward. 60 mL of nonionie contrast media was injected thorough elbow vein within 90 s and then take the first photo at 3 min to 5 rain and the second at 10 min to 15 rain. 30 minutse or more were required if diagnosis need. Results Before IVP, 23 patients whose preparation level were common, 14 patienst were good and 4 patients were excellent. In all patients, 89. 1 per cent （ n = 41 ） could accept IVP. 10. 9 per cent （ n = 5 ） could not to it because of poor preparation . Renal outline, corter and medulla could be observed clearly in 41 patients at 30 s to 40 s after IVP, 40 tatients begin to obtain full shape of unilateral or bilateral renal pelvis and renal caliees at 5 min, 45 patients obtained full shape of ureter at 15 min after IVP. Conclusion Careful enteric cavity preparation is the basis of IVP. Routine preparation is important, as well as avoid taking aerogenie foods during 3 days heford IVP, avoid more words before IVP, at the same time, prohibit elyster. The photo of renal parenchyma sould be taken at 30 s to 40 s after injecting contrast media. The photo of whole urinary system can be taken on the same X-ray film befor the end of IVP.