青年人腹腔积液46例病因分析

目的 探讨青年人腹腔积液的病因及临床特点,为进一步诊断治疗提供依据.方法 年龄35岁以下腹腔积液待查患者46例,均进行腹腔积液常规生化、病理及超声、CT、血肿瘤系列等多项检查,部分患者行胃肠镜及剖腹探查术.结果 46例患者中结核性腹膜炎21例(45.6%),结肠癌2例(4.3%),肝硬化2例(4.3%),恶性腹膜间皮瘤2例(4.3%),Budd-chiari综合征2例(4.3%),肝豆状核变性2例(4.3%),卵巢癌1例(2.1%),腹膜假性粘液瘤2例(4.3%),恶性淋巴瘤2例(4.3%,其中1例合并淋巴细胞性白血病),系统性红斑狼疮2例(4.3%),胃平滑肌肉瘤1例(2.1%),产后低蛋白血症1例(2.1%).特发性门静脉高压1例(2.1%),嗜酸细胞性胃肠炎l例(2.1%),病因未明4例(8.7%).结论 以腹腔积液待查就诊的青年患者,病因学分析最多为结核性腹膜炎,占45.6%,其次为与门静脉高压有关的腹腔积液、恶性肿瘤及结缔组织病,还有一些少见病因如嗜酸细胞性胃肠炎、腹膜假性粘液瘤等.

An etiologic study of 46 young cases with ascites

Objective To explore the etiology and clinical characteristics for young patients with aseites as main manifestation. Methods 46 cases admitted with a diagnosis of unknown ascites were retrospectively analyzed. These cases were examined by ascites examination, endoscopy, ultrasonography, angiography and exploratory laparoto-my. Results In 46 eases,21 (45.6%) of them were found to have tuberculous peritonitis ;2(4.3%)colon cancer,2(4.3%)liver cirrhosis,2(4.3%) asmalignant peritoneal mesotheliorna,2(4.3%)Budd -chiari syndrome,2(4.3%) bepatolenticular degeneration HLD,2(4.3%) ovarian cancer ,2(4.3%) peritoneal pseudomyxoma,2(4.3%) maglig- nant lymphoma and myelogenous leukemia, 2(4.3%) SLE,1(2.1%) leiomyosarcoma of stomach,1(2.1%) Hy- poalbuminemia of postpartum, 1 ( 2.1% ) idiopathic portal hypertension (IPH),1(2.1%) eosinophilic gastroenteritis,4(8.7%) with no final diagnosis. Conclusion The first cause of young patients with ascites is tuberculous peritoni- tis ,the second causes are ascites about portal hypertension/malignant tumor and connective tissue disease. Rare cau- ses are eosinophilic gastroenteritis,and so on.