Intravenous pyelogram
Principle and scope of application
Organic iodine for IVP is divided into two types: ionic and non-ionic. The former may cause side effects and should be tested for iodine allergy before use, and commonly used drugs include pantethine. The latter is now available in the clinic, such as uvexan, amipaque, omnipaque, etc., which basically have no side effects and generally do not require allergy testing before use. Therefore, non-ionic contrast agents should be used for the examination of those who have positive allergy tests for ionic contrast agents or have poor systemic conditions and must undergo IVP. [1]
Preparation for urography
Generally, gas-producing foods such as milk, soy products, pasta, and sugar should be abstained from three days prior to the imaging. The night before the imaging, cite the laxative prescribed by the doctor, senna, as if it were a tea, preferably with a few more cups, and have the stool expelled at any time. The purpose is to expel the residue from the intestine and cleanse the intestine. An iodine allergy test should also be done before the examination.
Drinking water is forbidden for 12 hours before the imaging, and no breakfast is allowed in the morning of the same day, while the breakfast mentioned here is dripping water. Gas in the intestine is mainly swallowed, and swallowing things and talking can cause gas to enter the intestine. Therefore, it is important to talk less and walk more to facilitate the expulsion of gas.
Urination and defecation are required before imaging to make the intestine and bladder empty.
Routine examination steps.
A supine abdominal plain film (KUB) is taken routinely, an abdominal compression band is prepared, 20 ml of contrast agent (76 compound pantopamine, maximum dose not exceeding 40 ml, nowadays non-ionic contrast agent iodophoresis is usually chosen) is injected intravenously, while the abdomen is pressurized (the specific pressure varies from person to person), after the injection, the intravenous access is reserved and the timing is started (the intravenous access is reserved for first aid in case of allergic reaction). The patient must hold his breath after each shot, especially the last one. For the sake of insurance, several shots can be taken in a row at the end.
Indications.
1, kidney, ureter and bladder tuberculosis, tumors, etc.
2. Unexplained hematuria.
3.Urological stones, to determine the site of stones and to know whether there are negative stones.
Clinical significance
Intravenous pyelogram can understand the location of the kidney and ureter, the secretory function of the kidney, and the relationship between retroperitoneal lesions and the organs of the urinary tract.
Contraindications.
1, renal failure: This test is contraindicated in patients with renal failure because of the low concentration of contrast agent in the urine, poor visualization, and possible toxicity to the kidneys, leading to deterioration of renal function.
2, iodine allergy: patients who are allergic to iodine, apply desensitizing drugs before imaging. If the iodine allergy test is negative, there is still a possibility of allergic reaction and close observation is required during the imaging procedure.
3.Pregnant women: In order to avoid the influence of X-rays on embryonic development, so pregnant women need to be strictly controlled. The imaging examination for women in their reproductive years should be performed within 10 days after menstruation.
4.Multiple myeloma: When intravenous urography is performed in patients with this disease, urinary closure may occur, especially in patients with oliguria, so this examination is not recommended.