196例结核性腹膜炎临床诊断探讨

目的分析结核性腹膜炎的临床特点,探讨其诊断方法。方法回顾分析196例住院确诊的结核性腹膜炎病例。结果各项检查的阳性率分别为血沉增快79.1%（155/196）,PPD阳性62.9%（117/186）,结核抗体39.7%（58/146）,腹部B超78.2%（153/196）,腹部CT 49.1%（53/108）,胸部X线片40.8%（80/196）,ADA73.1%（19/26）,腹水查结核杆菌1.2%（1/81）,胃镜检查55.8%（33/56）,腹腔镜87.5（28/32）,腹膜活检100%（10/10）。结论腹腔镜及腹膜活检对结核性腹膜炎诊断的阳性率最高,但均为有创性,临床应用受到一定限制,故应结合临床表现,各项辅助检查及抗结核治疗有效综合加以诊断。

Exploratory work on clinical diagnosis of tuberculosis peritonitis(analysis of cases attached)

Objective: To analyze the clinical characteristics of tuberculosis peritonitis and explore the diagnostic methods.Methods:Analyze 196 cases who had tuberculosis peritonitis diagnoded in our hospital retrospectively.Results: 79.1% of the cases have increased blood sedimentation rates.39.7% have anti-tuberculosis antibody.PPDtestings are positive in 62.9% of the cases.Abdomen B-ultrasonic examinations are positive in 78.2%.Abdomen CT examinations are positive in 49.1%.X-ray examinations of breast are positive in 87.5%.Peritoneum bispoy is positive in 100%.Conclusion: The rates of positive cases are highest in celioscope examination and peritoneum bispoy.But the two examining methods are harmful to patients abd should be limited in clinic.So cinical doctors should make diagnosis on the basis of clinical characteristics,accessorial examinations and the effect of anti-tuberculosis therapy.