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目的探讨CT检查在鉴别结核性腹膜炎与感染性腹膜炎中的作用。方法选取沈阳急救中心2014年2月至2015年8月收治的经病理学证实的33例结核性腹膜炎患者、34例感染性腹膜炎作为研究对象,比较两种病变各项CT征象的阳性率。结果两组患者腹水量比较差异有统计学意义(P<0.05),其中结核性腹膜炎表现为中少量腹水,感染性腹膜炎则腹水量较多;结核性腹膜炎壁层腹膜多见均匀增厚;感染性腹膜炎壁层腹膜增厚多呈结节样,未见异常;结核性腹膜炎、感染性腹膜炎患者大网膜均存在污迹样改变,可见增厚情况,淋巴结体积均明显增大,伴随强化现象。结论 CT检查在鉴别结核性腹膜炎与感染性腹膜炎中作用明显,腹水量、壁层腹膜改变是两种病变重要的、可区分的CT征象。
Objective To investigate the role of CT in the differential diagnosis of tuberculous peritonitis and infectious peritonitis. Methods Thirty-three patients with tuberculous peritonitis who were confirmed by pathology from February 2014 to August 2015 in Shenyang Emergency Center were selected and 34 patients with infectious peritonitis were selected as the research object to compare the positive rates of CT signs of the two diseases. Results There was significant difference in ascites volume between the two groups (P <0.05). Tuberculous peritonitis showed a small amount of ascites and infectious peritonitis with more ascites. Peritoneal parietal peritoneal thickening of the nodules were mostly, no abnormalities; tuberculous peritonitis, infectious peritonitis in patients with omental changes exist stain-like changes, showing thickening, lymph node volume were significantly increased, with the strengthening of the phenomenon . Conclusion The CT examination has significant effect on the differential diagnosis of tuberculous peritonitis and infectious peritonitis. Ascites volume and parietal peritoneal changes are important and distinguishable CT signs of both lesions.