经皮穿刺腹膜活检对不明原因腹水的诊断意义  

Value of percutaneous peritoneal biopsy in diagnosis of ascites of uncertain etiology

作　　者：黄家淼[1] 杨剑[1] 周仁荣[1] 

机构地区：[1]解放军第81医院,江苏南京210002

出　　处：《东南国防医药》2006年第4期247-248,共2页Military Medical Journal of Southeast China

摘　　要：目的 评价经皮腹腔穿刺腹膜活检对不明原因腹水的诊断价值。方法 应用张忠兵等改良的cope活检针，对经B超、胃肠内窥镜和（或）消化道造影、CT和（或）MRI、各种生化和腹水细胞学检查无法确定病因的26例腹水患者行经皮腹腔穿刺腹膜活检。结果 26例患者均经一次穿刺分别取出2～4块腹膜壁层组织，经病理证实转移性腺癌7例、粘液腺癌2例、腹膜间皮瘤1例、结核性腹膜炎8例、嗜酸性肉芽肿1例和大致正常腹膜组织7例，一次穿刺活检成功率为100％，经活检明确腹水病因的诊断率为73．1％（19／26）。结论 经皮穿刺腹膜活检对不明原因腹水的诊断，特别是对腹膜肿瘤和结核性腹膜炎的鉴别诊断，具有重要的价值。Objective To evaluate the value of percutaneous peritoneal biopsy in diagnosis of ascites of uncertain etiology. Methods 26 cases with ascites of unknown origin were percutaneous peritoneal biopsied with cope＇s biopsy needle modified by Zhang Zhongbing et al, their etiologies couldn＇t be confirmed by ultrasound, endoscopic and/or radiographic imaging, CT and/or MRI, and diagnostic paracentesis for biochemical content and cytology. Results 2～ 4 pieces of tissues of peritoneal peritoneum were achieved respectively from each of the 26 cases of patients only by one puncture, biopsy success rate was 100%. 19/26 cases （73. 1 % ） were correctly diagnosed. There were peritoneal metastatic adenocarcinoma （n = 7）, carcinoma mucocellulare （n = 2）, peritoneal mesothelioma （n=1）, peritoneal tuberculosis （n=8）, eosinophilic granuloma （n=1）. But 7 cases ascites were not diagnosed finally for roughly normal peritoneum tissues. Conclusion Percustaneous peritoneal biopsy is valuable in diagnosis of ascites of uncertain etiology, especially in the differential diagnosis of malignant aseites and TB peritonitis.

关 键 词：腹水 诊断 腹膜活检 

分 类 号：R442.5[医药卫生—诊断学]