摘要
目的分析结核性腹膜炎(tuberculosis peritonitis,TBP)的临床特点和实验室检查,探讨各种诊断方法在TBP诊断中的应用。方法回顾分析116例以腹水待查入院并得到确诊的TBP病例,对其临床特点、实验室检查及诊断方法进行总结分析。结果各项检查的阳性率分别为PPD 53.5%(38/71),TB-Ab 15.4%(2/13),CA125 92.4%(61/66),CEA 29.1%(23/79),CA199 1.7%(1/60),ADA 83.3%(20/24),腹膜活检47.6%(10/21),腹腔镜80%(4/5),剖腹探查100%(10/10)。各种诊断方法诊断的例数所占比例分别为诊断性治疗77.6%(90/116),淋巴结活检1.7%(2/116),腹膜活检8.6%(10/116),腹腔镜3.4%(4/116),剖腹探查8.6%(10/116)。结论诊断性治疗是TBP确诊的主要方法。腹膜活检、腹腔镜及剖腹探查对TBP诊断的阳性率高,在有适应证的前提下应适时、及早进行。
Objective To analyze the clinical characteristics and laboratory examinations of tuberculosis peritonitis and explore the vavious diagnostic ways in the application of the diagnosis for TBP. Methods Retrospectively analyzed 116 cases with tuberculosis peritonitis admitted with ascites of unknown origin about their clinical symptoms, signs, laboratory examina- tions, diagnostic procedures and routes. Results The positive rate of the examination was 53.5% for PPD, 15.4% for TB-Ab, 92.4% for CA125,29.1% for CEA, 1.7% for CA199,83.3% for ADA. The positive rate of peritoneum biopsy, laporoscopic explo- ration and exploratory laparotomy was 47.6%, 80%, 100%, respectively. The proportion of the patients taken different diagnostic methods were experimental anti-tuberculosis treatment accounting for 77.6%, endoscopy accounting for 1.7%, peritoneum biop- sy accounting for 8.6%, laporoscopic exploration accounting for 3.4%, exploratory laparotomy accounting for 8.6%. Conclu- sion Experimental anti-tuberculosis treatment is the main way for the diagnostic tuberculosis peritonitis. Peritoneum biopsy, laporoscopic exploration and exploratory laparotomy should be properly started early if the patient has the indication.
出处
《中国现代医药杂志》
2014年第1期38-41,共4页
Modern Medicine Journal of China
关键词
结核性腹膜炎
腹水
诊断
Tuberculosis peritonitis Ascites Diagnosis
