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目的探讨CT引导下经皮穿刺腹膜活检对不明原因腹腔积液的诊断价值。方法回顾性分析西南医院2011年5月23日至2016年8月2日常规检查未能明确病因的106例腹腔积液行CT引导下经皮穿刺腹膜活检术患者的临床资料，统计腹膜穿刺活检对诊断腹腔积液的敏感性与特异性，同时收集穿刺活检的并发症，评估穿刺安全性。结果106例不明原因腹腔积液患者行CT引导下腹膜穿刺活检术，经病理组织学明确诊断有91例，占85.85%，其中恶性60例(56.60%)，良性31例(29.25%)；非诊断结论组（慢性炎和纤维脂肪组织）15例，占14.15%。CT引导下经皮腹膜穿刺活检术对本研究组人群诊断的敏感性为88.35%，特异度100%，显著优于腹水细胞学及腹水常规、生化等化验。所有患者均未出现严重并发症。结论CT引导下经皮穿刺腹膜活检对不明原因腹腔积液的确诊率高，是一种安全、有效的诊断方法。
Objective To investigate the diagnostic value of percutaneous peritoneal biopsy guided by CT in the diagnosis of unexplained ascites. Methods We retrospectively analyzed the clinical data of 106 patients with peritoneal biopsy under CT-guided peritoneal effusion routinely diagnosed in Southwest Hospital from May 23, 2011 to August 2, 2016. The peritoneal biopsy To diagnose the sensitivity and specificity of ascites, collect the complications of puncture biopsy and evaluate the puncture safety. Results Of the 106 patients with unexplained ascites, CT-guided peritoneal biopsy showed that there were 91 cases (85.85%) diagnosed by histopathology, of which malignant in 60 cases (56.60%) and benign in 31 cases (29.25%); The diagnosis of the conclusion group (chronic inflammation and fibrous adipose tissue) 15 cases, accounting for 14.15%. CT-guided percutaneous peritoneal biopsy of the study group of patients with a sensitivity of 88.35%, 100% specificity, significantly better than the ascites cytology and ascites routine, biochemical and other tests. No serious complications occurred in all patients. Conclusion CT-guided percutaneous biopsy of peritoneal effusion for the diagnosis of unexplained high rate is a safe and effective diagnostic method.