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目的评价多功能腹膜检查针在结核性腹膜炎诊断中的应用价值。方法2001年1月至2005年9月对第二军医大学附属上海长征医院消化内科收治的27例结核性腹膜炎住院患者中19例用自制多功能腹膜检查针行腹膜活检,并与患者的临床表现、辅助检查、腹腔镜等检查结果进行比较。结果27例患者中,5例根据症状、体征、血沉、血清和腹水癌抗原(CA125)以及腺苷脱氨酶(ADA)、抗结核抗体、腹水抗酸染色、PPD试验高度考虑结核性腹膜炎,余22例临床诊断依据不足的患者中,19例行腹膜检查针活检,其中14例病理报告提示腹膜结核病,确诊率73.68%,5例病理报告提示纤维组织增生、慢性炎性细胞浸润,不排除腹膜结核病,疑诊率26.32%;另外3例行腹腔镜检查确诊。结论自制多功能腹膜检查针行腹膜活检,操作简单,创伤性小,病理确诊率高,在无腹腔镜的单位或无条件进行腹腔镜检查的疑似结核性腹膜炎患者中,进行该项检查更具实用价值。
Objective To evaluate the value of multifunctional peritoneal dialysis needle in the diagnosis of tuberculous peritonitis. Methods From January 2001 to September 2005, 19 patients with tuberculous peritonitis admitted to Department of Gastroenterology, Shanghai Changzheng Hospital affiliated to the Second Military Medical University from January 2001 to September 2005 were treated with self-made multi-function peritoneal examination for peritoneal biopsy and were compared with the clinical manifestations , Auxiliary examination, laparoscopy and other test results were compared. Results Among the 27 patients, tuberculous peritonitis was highly considered in 5 patients on the basis of symptoms, signs, ESR, CA125 and adenosine deaminase (ADA), anti-TB antibody, acid-fast staining of ascites and PPD test. Of the 22 patients with inadequate clinical diagnosis, 19 patients underwent peritoneal needle biopsy, of which 14 cases reported peritoneal tuberculosis with a diagnosis rate of 73.68%. Five cases of pathological findings suggested fibrosis and chronic inflammatory cell infiltration, which were not excluded Peritoneal tuberculosis, suspected rate was 26.32%; the other 3 cases were diagnosed by laparoscopy. Conclusion Self-made multi-function peritoneal biopsy needle peritoneal biopsy, simple operation, less traumatic, high pathological diagnosis, in the absence of laparoscopic units or unconditional laparoscopic suspected tuberculous peritonitis patients, the more practical inspection value.