腹腔探查对结核性腹膜炎诊断价值的临床观察研究

目的:探究腹腔探查对结核性腹膜炎诊断价值的研究,为临床提供指导。方法:以2010年1月1日—2018年4月30日我院37例疑似结核性腹膜炎患者作为观察对象,对37例疑似结核性腹膜炎患者均实施术前CT检查,其中13例行腹腔镜探查,24例行开腹探查,将CT检查结果、腹腔探查结果和术后病理活检结果进行比较,研究对比腹腔探查对结核性腹膜炎的诊断结果。结果:36例腹腔探查取腹膜活检病理回报证实为结核性腹膜炎,其中1例未确证结核性腹膜炎。腹腔探查诊断结核性腹膜炎的敏感度、特异度、总准确率分别为90%、100.00%、97.30%,CT诊断结核性腹膜炎的敏感度、特异度、总准确率分别为60.00%、50.00%、56.76%,腹腔探查诊断结核性腹膜炎的总准确率相比CT明显更高,P0.05;腹腔探查可有效对结核性腹膜炎进行分型诊断,总符合率为90.00%,将腹腔探查结果和术后病理活检结果进行对比发现,P0.05。结论:对结核性腹膜炎患者采取腹腔探查切实可行,具有较高的准确率,可为临床医师分析病情提供依据。

Clinical Observation on Diagnostic Value of Abdominal Exploration for Tuberculous Peritonitis

Objective To explore the value of abdominal exploration in the diagnosis of tuberculous peritonitis, and provide guidance for the clinic. Methods From January 1, 2010 to April 30, 2010, 37 patients with suspected tuberculous peritonitis were enrolled in the study. All patients with suspected tuberculous peritonitis underwent preoperative CT and abdominal exploration, among which 13 patients underwent laparoscopic exploration and 24 patients underwent open surgery. The results of the CT examination, abdominal exploration and postoperative pathological biopsy were compared to study the diagnosis of tuberculous peritonitis by abdominal exploration. Results The pathological findings of peritoneal biopsy by laparotomy were confirmed as tuberculous peritonitis, and one of them did not confirm tuberculous peritonitis. The sensitivity, specificity and total accuracy of laparoscopic exploration for tuberculous peritonitis were 90%, 100.00% and 97.30%, respectively. The sensitivity, specificity and total accuracy of CT diagnosis of tuberculous peritonitis were 60.00%, 50.00%, and 56.76%, respectively. The total accuracy of abdominal cavity exploration for diagnosis of tuberculous peritonitis was significantly higher than that of CT (P<0.05); the abdominal exploration could effectively diagnose tuberculous peritonitis, the total coincidence rate was 90.00%, and the results of abdominal exploration and the results of postoperative pathological biopsy were compared and found P>0.05. Conclusion Abdominal exploration for patients with tuberculous peritonitis is feasible and has a high accuracy rate, which can provide a basis for clinicians to analyze the condition.