多功能腹膜检查针对良恶性腹水的鉴别诊断

目的评价多功能腹膜检查针在良恶性腹水鉴别诊断中的价值。方法回顾比较327例住院腹水患者用多功能腹膜检查针进行活检、刷检及活检刷检前后腹水细胞学检查结果。结果327例腹水患者最终均已明确诊断,多功能腹膜检查针检查活检前细胞学、腹膜活检、腹膜刷检,及活检刷检后腹水细胞学检查,良性腹水各项检查结果均为良性,特异度均为100%。恶性腹水189例中,经活检前细胞学检查明确诊断者101例,灵敏度53.4%;经活检明确诊断者171例,灵敏度90.5%;经刷检明确诊断者157例,灵敏度83.1%;经活检刷检后细胞学明确诊断者170例,灵敏度90.0%;而多功能腹膜活检针三项检查综合确诊者177例,灵敏度93.7%。有6例为刷检未明确诊断,而在活检及活检刷检后细胞学明确诊断者;7例仅在活检中明确诊断;6例仅在刷检后细胞学明确诊断。活检、刷检及活检刷检后的细胞学检查的诊断灵敏度均明显高于活检前腹水细胞学检查(χ2=64.241、38.288、62.064,P<0.001);活检和刷检相比,活检诊断灵敏度明显高于刷检(χ2=4.518,P<0.05);活检刷检后细胞学检查灵敏度与单一刷检相比明显升高(χ2=3.831,P<0.05),而活检和活检刷检后细胞学检查无统计学差异;单一活检、单一活检刷检后细胞学检查和多功能腹膜检查针三项检查综合相比无显著性差异。多功能腹膜检查针对良恶性腹水的诊断灵敏度达93.7%,准确度达96.3%。结论多功能腹膜检查针对良恶性腹水鉴别诊断具有较大的价值。

The value of the multifunctional peritoneal biopsy needle in diagnosing benign and malignant ascites

Objective To identify the value of the multifunctional peritoneal biopsy needle in diagno-sing benign and malignant ascites.Methods The data of the 327 patients with ascite who had underwent the multifunctional peritoneal biopsy needle in author's hospital were analysed and compared retrospectively. Results The 327 patients of ascite were diagnosed finally. The diagnosis sensitivity and specificity of ascitic cytology before undergoing the multifunctional peritoneal biopsy needle in discriminating malignant was 53.4% and 100%, the diagnosis sensitivity and specificity of biopsy was 90.5% and 100%, the diagnosis sensitivity and specificity of peritoneal brush was 83.1% and 100%, the diagnosis sensitivity and specificity of ascitic cytology after peritoneal brush was 90.0% and 100%, the diagnosis sensitivity and specificity of co-examination was 93.7% and 100%. The sensitivity of biopsy, peritoneal brush, ascitic cytology after peritoneal brush was much higher than ascitic cytology before undergoing the multifunctional peritoneal biopsy needle (χ2=64.241,38.288,62.064,P<0.001). the biopsy much higher than peritoneal brush(χ2=4.518,P<0.05), the ascitic cytology after peritoneal brush much higher than peritoneal brush(χ2=3.831,P<0.05). The multifunctional peritoneal biopsy needle had a sensitivity of 93.7% and a accuracy of 96.3% in diagnosis of benign and malignant ascites.ConclusionThe multifunctional peri-toneal biopsy needle has a better value in diagnosing benign and malignant ascites.